How much rates vary
Facilitymedian $39 · 10th to 90th $32 to $87Professionalmedian $31 · 10th to 90th $23 to $72
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 $17.38 Median $21.88 Typical High $32.36 | Facility | None | $17.38 | $21.88 | $32.36 |
Aetna Setting Professional Modifier None (both parts) Typical Low $21.88 Median $21.88 Typical High $32.36 | Professional | None (both parts) | $21.88 | $21.88 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $52.48 Typical High $104.71 | Facility | None | $51.29 | $52.48 | $104.71 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $27.54 Median $27.54 Typical High $87.10 | Professional | None (both parts) | $27.54 | $27.54 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $5.89 | Professional | RR · Rental | $2.75 | $2.75 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $36.31 | Professional | UE · Used equipment | $20.42 | $20.42 | $36.31 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None (both parts) | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $38.90 | Facility | None | $34.67 | $34.67 | $38.90 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None (both parts) | $25.70 | $25.70 | $25.70 |
Emblem Health Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $186.21 | Facility | None | $51.29 | $85.11 | $186.21 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $33.88 Median $51.29 Typical High $91.20 | Professional | None (both parts) | $33.88 | $51.29 | $91.20 |
Excellus BCBS Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $29.51 Median $38.90 Typical High $42.66 | Professional | None (both parts) | $29.51 | $38.90 | $42.66 |
MVP Health Care Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $31.62 Median $31.62 Typical High $75.86 | Professional | None (both parts) | $31.62 | $31.62 | $75.86 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $83.18 | Facility | None | $63.10 | $63.10 | $83.18 |
United Setting Professional Modifier None (both parts) Typical Low $16.98 Median $26.92 Typical High $38.02 | Professional | None (both parts) | $16.98 | $26.92 | $38.02 |
Univera Setting Facility Modifier None Typical Low $29.51 Median $38.90 Typical High $38.90 | Facility | None | $29.51 | $38.90 | $38.90 |
Univera Setting Professional Modifier None (both parts) Typical Low $29.51 Median $38.90 Typical High $42.66 | Professional | None (both parts) | $29.51 | $38.90 | $42.66 |
5 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 $10.96 Median $10.96 Typical High $15.85 | Professional | 52 · Reduced service | $10.96 | $10.96 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $6.46 | Professional | 53 · Discontinued | $4.47 | $4.47 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $4.79 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $3.24 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $1.86 Median $2.09 Typical High $2.75 | Professional | 26 · Professional part | $1.86 | $2.09 | $2.75 |
Where New York sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 26th of 51
$30.90
MT $54.95NJ $25.70
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.