How much rates vary
Facilitymedian $28 · 10th to 90th $21 to $65Professionalmedian $23 · 10th to 90th $16 to $55
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 $12.59 Median $16.22 Typical High $23.44 | Facility | None | $12.59 | $16.22 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $23.44 | Professional | None | $16.22 | $16.22 | $23.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $38.90 Typical High $75.86 | Facility | None | $38.02 | $38.90 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $66.07 | Professional | None | $20.89 | $20.89 | $66.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.04 Median $2.04 Typical High $4.47 | Professional | RR · Rental | $2.04 | $2.04 | $4.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $15.49 Typical High $28.18 | Professional | UE · Used equipment | $15.49 | $15.49 | $28.18 |
CDPHP Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $23.44 | Facility | None | $21.38 | $21.38 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Emblem Health Setting Facility Modifier None Typical Low $38.02 Median $63.10 Typical High $138.04 | Facility | None | $38.02 | $63.10 | $138.04 |
Emblem Health Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $67.61 | Professional | None | $24.55 | $38.02 | $67.61 |
Excellus BCBS Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $21.88 Median $28.18 Typical High $30.90 | Professional | None | $21.88 | $28.18 | $30.90 |
MVP Health Care Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
MVP Health Care Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $56.23 | Professional | None | $22.91 | $22.91 | $56.23 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $60.26 | Facility | None | $46.77 | $46.77 | $60.26 |
United Setting Professional Modifier None Typical Low $12.30 Median $19.95 Typical High $28.18 | Professional | None | $12.30 | $19.95 | $28.18 |
Univera Setting Facility Modifier None Typical Low $21.38 Median $28.18 Typical High $28.18 | Facility | None | $21.38 | $28.18 | $28.18 |
Univera Setting Professional Modifier None Typical Low $21.88 Median $28.18 Typical High $30.90 | Professional | None | $21.88 | $28.18 | $30.90 |
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 $8.13 Median $8.13 Typical High $11.75 | Professional | 52 · Reduced service | $8.13 | $8.13 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $4.68 | Professional | 53 · Discontinued | $3.24 | $3.24 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $3.55 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.34 |
Where New York sits
The same service costs 3.1 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· 20th of 51
$22.91
MT $40.74KS $13.18
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.