How much rates vary
Facilitymedian $36 · 10th to 90th $34 to $102Professionalmedian $36 · 10th to 90th $26 to $91
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 $20.42 Median $26.30 Typical High $38.02 | Facility | None | $20.42 | $26.30 | $38.02 |
Aetna Setting Professional Modifier None (both parts) Typical Low $26.30 Median $26.30 Typical High $102.33 | Professional | None (both parts) | $26.30 | $26.30 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $123.03 | Facility | None | $61.66 | $61.66 | $123.03 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $34.67 Median $34.67 Typical High $107.15 | Professional | None (both parts) | $34.67 | $34.67 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $7.24 | Professional | RR · Rental | $3.31 | $3.31 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $47.86 | Professional | UE · Used equipment | $25.12 | $25.12 | $47.86 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None (both parts) | $50.12 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $38.02 | Facility | None | $33.88 | $33.88 | $38.02 |
Cigna Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None (both parts) | $25.12 | $25.12 | $33.88 |
Emblem Health Setting Facility Modifier None Typical Low $61.66 Median $100.00 Typical High $218.78 | Facility | None | $61.66 | $100.00 | $218.78 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $39.81 Median $61.66 Typical High $107.15 | Professional | None (both parts) | $39.81 | $61.66 | $107.15 |
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 (both parts) Typical Low $34.67 Median $36.31 Typical High $50.12 | Professional | None (both parts) | $34.67 | $36.31 | $50.12 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $48.98 | $48.98 | $48.98 |
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 (both parts) Typical Low $42.66 Median $42.66 Typical High $89.13 | Professional | None (both parts) | $42.66 | $42.66 | $89.13 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $97.72 | Facility | None | $74.13 | $74.13 | $97.72 |
United Setting Professional Modifier None (both parts) Typical Low $19.95 Median $31.62 Typical High $44.67 | Professional | None (both parts) | $19.95 | $31.62 | $44.67 |
Univera Setting Facility Modifier None Typical Low $33.88 Median $36.31 Typical High $36.31 | Facility | None | $33.88 | $36.31 | $36.31 |
Univera Setting Professional Modifier None (both parts) Typical Low $34.67 Median $36.31 Typical High $50.12 | Professional | None (both parts) | $34.67 | $36.31 | $50.12 |
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 $12.88 Median $12.88 Typical High $19.05 | Professional | 52 · Reduced service | $12.88 | $12.88 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $7.59 | Professional | 53 · Discontinued | $5.25 | $5.25 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $5.62 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $3.80 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $2.34 Median $3.09 Typical High $4.07 | Professional | 26 · Professional part | $2.34 | $3.09 | $4.07 |
Where New York sits
The same service costs 2.8 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· 22nd of 51
$36.31
MT $64.57KS $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.