How much rates vary
Facilitymedian $58 · 10th to 90th $48 to $174Professionalmedian $58 · 10th to 90th $44 to $145
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 $33.88 Median $43.65 Typical High $63.10 | Facility | None | $33.88 | $43.65 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $63.10 | Professional | None | $43.65 | $43.65 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $104.71 Typical High $204.17 | Facility | None | $102.33 | $104.71 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $173.78 | Professional | None | $53.70 | $53.70 | $173.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $11.75 | Professional | RR · Rental | $5.37 | $5.37 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $72.44 | Professional | UE · Used equipment | $40.74 | $40.74 | $72.44 |
CDPHP Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $169.82 Typical High $371.54 | Facility | None | $102.33 | $169.82 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $181.97 | Professional | None | $66.07 | $102.33 | $181.97 |
Excellus BCBS Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $83.18 | Professional | None | $47.86 | $58.88 | $83.18 |
MVP Health Care Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
MVP Health Care Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $147.91 | Professional | None | $61.66 | $61.66 | $147.91 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $162.18 | Facility | None | $125.89 | $125.89 | $162.18 |
United Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $72.44 | Professional | None | $33.11 | $52.48 | $72.44 |
Univera Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Facility | None | $47.86 | $47.86 | $58.88 |
Univera Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $83.18 | Professional | None | $47.86 | $58.88 | $83.18 |
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 $21.88 Median $21.88 Typical High $31.62 | Professional | 52 · Reduced service | $21.88 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $12.59 | Professional | 53 · Discontinued | $8.71 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $9.55 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $6.31 |
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· 26th of 51
$57.54
MT $110DE $41.69
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.