How much rates vary
Facilitymedian $56 · 10th to 90th $50 to $151Professionalmedian $50 · 10th to 90th $41 to $120
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 $29.51 Median $38.02 Typical High $54.95 | Facility | None | $29.51 | $38.02 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | None | $38.02 | $38.02 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $91.20 Typical High $177.83 | Facility | None | $89.13 | $91.20 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $151.36 | Professional | None | $46.77 | $47.86 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $4.68 Typical High $10.23 | Professional | RR · Rental | $4.68 | $4.68 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $63.10 | Professional | UE · Used equipment | $34.67 | $34.67 | $63.10 |
CDPHP Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $61.66 | Facility | None | $56.23 | $56.23 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Emblem Health Setting Facility Modifier None Typical Low $89.13 Median $144.54 Typical High $316.23 | Facility | None | $89.13 | $144.54 | $316.23 |
Emblem Health Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $154.88 | Professional | None | $57.54 | $89.13 | $154.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $72.44 | Professional | None | $50.12 | $52.48 | $72.44 |
MVP Health Care Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
MVP Health Care Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $128.82 | Professional | None | $53.70 | $53.70 | $128.82 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $141.25 | Facility | None | $107.15 | $107.15 | $141.25 |
United Setting Professional Modifier None Typical Low $28.84 Median $45.71 Typical High $64.57 | Professional | None | $28.84 | $45.71 | $64.57 |
Univera Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $52.48 | Facility | None | $50.12 | $52.48 | $52.48 |
Univera Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $72.44 | Professional | None | $50.12 | $52.48 | $72.44 |
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 $19.05 Median $19.05 Typical High $27.54 | Professional | 52 · Reduced service | $19.05 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $10.96 | Professional | 53 · Discontinued | $7.59 | $7.59 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $5.50 |
Where New York sits
The same service costs 3.1 times more in Hawaii 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· 28th of 51
$50.12
HI $93.33KS $30.20
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.