How much rates vary
Facilitymedian $42 · 10th to 90th $32 to $95Professionalmedian $32 · 10th to 90th $24 to $79
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $19.05 Median $23.99 Typical High $34.67 | Facility | None | $19.05 | $23.99 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $34.67 | Professional | None | $23.99 | $23.99 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $57.54 Typical High $112.20 | Facility | None | $56.23 | $57.54 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $97.72 | Professional | None | $30.90 | $30.90 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $6.61 | Professional | RR · Rental | $3.09 | $3.09 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $40.74 | Professional | UE · Used equipment | $22.91 | $22.91 | $40.74 |
CDPHP Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $37.15 | Facility | None | $33.11 | $33.11 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Emblem Health Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $204.17 | Facility | None | $56.23 | $93.33 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $100.00 | Professional | None | $36.31 | $56.23 | $100.00 |
Excellus BCBS Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $45.71 | Professional | None | $32.36 | $41.69 | $45.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Highmark BCBS Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
MVP Health Care Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $83.18 | Professional | None | $26.30 | $26.30 | $83.18 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $89.13 | Facility | None | $69.18 | $69.18 | $89.13 |
United Setting Professional Modifier None Typical Low $18.20 Median $29.51 Typical High $41.69 | Professional | None | $18.20 | $29.51 | $41.69 |
Univera Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $41.69 | Facility | None | $31.62 | $41.69 | $41.69 |
Univera Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $45.71 | Professional | None | $32.36 | $41.69 | $45.71 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.02 Typical High $17.38 | Professional | 52 · Reduced service | $12.02 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $6.92 | Professional | 53 · Discontinued | $4.79 | $4.79 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $5.25 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $3.47 |
Where New York sits
The same service costs 2.6 times more in Montana than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 27th of 51
$32.36
MT $60.26KS $23.44
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.