How much rates vary
Facilitymedian $35 · 10th to 90th $33 to $100Professionalmedian $35 · 10th to 90th $25 to $83
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 $19.95 Median $25.12 Typical High $37.15 | Facility | None | $19.95 | $25.12 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $37.15 | Professional | None | $25.12 | $25.12 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $60.26 Typical High $120.23 | Facility | None | $58.88 | $60.26 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $100.00 | Professional | None | $30.90 | $30.90 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.16 Median $3.16 Typical High $6.76 | Professional | RR · Rental | $3.16 | $3.16 | $6.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.44 Median $23.44 Typical High $41.69 | Professional | UE · Used equipment | $23.44 | $23.44 | $41.69 |
CDPHP Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $37.15 | Facility | None | $33.11 | $33.11 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Emblem Health Setting Facility Modifier None Typical Low $58.88 Median $97.72 Typical High $213.80 | Facility | None | $58.88 | $97.72 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $104.71 | Professional | None | $38.90 | $58.88 | $104.71 |
Excellus BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $48.98 | Professional | None | $33.88 | $35.48 | $48.98 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
MVP Health Care Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $87.10 | Professional | None | $36.31 | $36.31 | $87.10 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $93.33 | Facility | None | $72.44 | $72.44 | $93.33 |
United Setting Professional Modifier None Typical Low $19.50 Median $30.90 Typical High $42.66 | Professional | None | $19.50 | $30.90 | $42.66 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $35.48 Typical High $35.48 | Facility | None | $33.11 | $35.48 | $35.48 |
Univera Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $48.98 | Professional | None | $33.88 | $35.48 | $48.98 |
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 $12.59 Median $12.59 Typical High $18.20 | Professional | 52 · Reduced service | $12.59 | $12.59 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $7.41 | Professional | 53 · Discontinued | $5.13 | $5.13 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $5.50 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $3.72 |
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· 22nd of 51
$35.48
MT $63.10DE $24.55
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.