How much rates vary
Facilitymedian $55 · 10th to 90th $44 to $123Professionalmedian $42 · 10th to 90th $36 to $100
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 $25.12 Median $31.62 Typical High $45.71 | Facility | None | $25.12 | $31.62 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | None | $31.62 | $31.62 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $75.86 Typical High $147.91 | Facility | None | $74.13 | $75.86 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $125.89 | Professional | None | $39.81 | $40.74 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $8.71 | Professional | RR · Rental | $3.98 | $3.98 | $8.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $53.70 | Professional | UE · Used equipment | $29.51 | $29.51 | $53.70 |
CDPHP Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $74.13 Median $123.03 Typical High $269.15 | Facility | None | $74.13 | $123.03 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $131.83 | Professional | None | $47.86 | $77.62 | $131.83 |
Excellus BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $60.26 | Professional | None | $43.65 | $54.95 | $60.26 |
MVP Health Care Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
MVP Health Care Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $109.65 | Professional | None | $43.65 | $43.65 | $109.65 |
United Setting Facility Modifier None Typical Low $43.65 Median $89.13 Typical High $117.49 | Facility | None | $43.65 | $89.13 | $117.49 |
United Setting Professional Modifier None Typical Low $24.55 Median $38.90 Typical High $53.70 | Professional | None | $24.55 | $38.90 | $53.70 |
Univera Setting Facility Modifier None Typical Low $43.65 Median $54.95 Typical High $54.95 | Facility | None | $43.65 | $54.95 | $54.95 |
Univera Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $60.26 | Professional | None | $43.65 | $54.95 | $60.26 |
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 $15.85 Median $15.85 Typical High $22.91 | Professional | 52 · Reduced service | $15.85 | $15.85 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $9.12 | Professional | 53 · Discontinued | $6.31 | $6.31 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $6.92 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $4.57 |
Where New York sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 31st of 51
$41.69
HI $123KY $39.81
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.