How much rates vary
Facilitymedian $36 · 10th to 90th $28 to $83Professionalmedian $28 · 10th to 90th $21 to $66
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 $16.22 Median $20.89 Typical High $30.20 | Facility | None | $16.22 | $20.89 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $30.20 | Professional | None | $20.89 | $20.89 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $50.12 Typical High $97.72 | Facility | None | $48.98 | $50.12 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $27.54 Typical High $83.18 | Professional | None | $26.92 | $27.54 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $5.75 | Professional | RR · Rental | $2.69 | $2.69 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $19.95 Typical High $36.31 | Professional | UE · Used equipment | $19.95 | $19.95 | $36.31 |
CDPHP Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $29.51 | Facility | None | $27.54 | $27.54 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Emblem Health Setting Facility Modifier None Typical Low $48.98 Median $81.28 Typical High $177.83 | Facility | None | $48.98 | $81.28 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $31.62 Median $48.98 Typical High $87.10 | Professional | None | $31.62 | $48.98 | $87.10 |
Excellus BCBS Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $28.18 Median $36.31 Typical High $39.81 | Professional | None | $28.18 | $36.31 | $39.81 |
MVP Health Care Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
MVP Health Care Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $70.79 | Professional | None | $29.51 | $29.51 | $70.79 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $77.62 | Facility | None | $60.26 | $60.26 | $77.62 |
United Setting Professional Modifier None Typical Low $15.85 Median $25.12 Typical High $35.48 | Professional | None | $15.85 | $25.12 | $35.48 |
Univera Setting Facility Modifier None Typical Low $27.54 Median $36.31 Typical High $36.31 | Facility | None | $27.54 | $36.31 | $36.31 |
Univera Setting Professional Modifier None Typical Low $28.18 Median $36.31 Typical High $39.81 | Professional | None | $28.18 | $36.31 | $39.81 |
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 $10.47 Median $10.47 Typical High $15.14 | Professional | 52 · Reduced service | $10.47 | $10.47 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $6.03 | Professional | 53 · Discontinued | $4.17 | $4.17 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $4.57 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $3.02 |
Where New York sits
The same service costs 2.6 times more in Montana than in Delaware. 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· 23rd of 51
$27.54
MT $52.48DE $19.95
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.