How much rates vary
Facilitymedian $39 · 10th to 90th $37 to $112Professionalmedian $37 · 10th to 90th $28 to $89
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 $21.88 Median $28.18 Typical High $40.74 | Facility | None | $21.88 | $28.18 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $40.74 | Professional | None | $28.18 | $28.18 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $67.61 Typical High $131.83 | Facility | None | $66.07 | $67.61 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $35.48 Typical High $112.20 | Professional | None | $34.67 | $35.48 | $112.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $7.59 | Professional | RR · Rental | $3.47 | $3.47 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $25.70 Typical High $51.29 | Professional | UE · Used equipment | $25.70 | $25.70 | $51.29 |
CDPHP Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $40.74 | Facility | None | $37.15 | $37.15 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Emblem Health Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $234.42 | Facility | None | $66.07 | $107.15 | $234.42 |
Emblem Health Setting Professional Modifier None Typical Low $42.66 Median $66.07 Typical High $117.49 | Professional | None | $42.66 | $66.07 | $117.49 |
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 Typical Low $37.15 Median $38.90 Typical High $53.70 | Professional | None | $37.15 | $38.90 | $53.70 |
Highmark BCBS Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
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 Typical Low $39.81 Median $39.81 Typical High $95.50 | Professional | None | $39.81 | $39.81 | $95.50 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $104.71 | Facility | None | $79.43 | $79.43 | $104.71 |
United Setting Professional Modifier None Typical Low $21.38 Median $33.88 Typical High $47.86 | Professional | None | $21.38 | $33.88 | $47.86 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $38.90 Typical High $38.90 | Facility | None | $37.15 | $38.90 | $38.90 |
Univera Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $53.70 | Professional | None | $37.15 | $38.90 | $53.70 |
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 $14.13 Median $14.13 Typical High $20.42 | Professional | 52 · Reduced service | $14.13 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | 53 · Discontinued | $5.62 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $6.03 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $4.07 |
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
$37.15
MT $69.18DE $26.92
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.