How much rates vary
Facilitymedian $107 · 10th to 90th $5 to $347Professionalmedian $110 · 10th to 90th $79 to $275
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 $64.57 Median $81.28 Typical High $117.49 | Facility | None | $64.57 | $81.28 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | None | $81.28 | $81.28 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $380.19 | Facility | None | $190.55 | $194.98 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $323.59 | Professional | None | $100.00 | $100.00 | $323.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $10.00 Typical High $21.88 | Professional | RR · Rental | $10.00 | $10.00 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $75.86 Typical High $134.90 | Professional | UE · Used equipment | $75.86 | $75.86 | $134.90 |
CDPHP Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $120.23 | Facility | None | $107.15 | $107.15 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $691.83 | Facility | None | $190.55 | $316.23 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $338.84 | Professional | None | $125.89 | $199.53 | $338.84 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.57 Median $109.65 Typical High $158.49 | Professional | None | $4.57 | $109.65 | $158.49 |
MVP Health Care Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
MVP Health Care Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $281.84 | Professional | None | $117.49 | $117.49 | $281.84 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $302.00 | Facility | None | $234.42 | $234.42 | $302.00 |
United Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $138.04 | Professional | None | $63.10 | $100.00 | $138.04 |
Univera Setting Facility Modifier None Typical Low $5.50 Median $109.65 Typical High $109.65 | Facility | None | $5.50 | $109.65 | $109.65 |
Univera Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $158.49 | Professional | None | $107.15 | $117.49 | $158.49 |
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 $40.74 Median $40.74 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $40.74 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $16.22 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $11.75 |
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· 25th of 51
$110
MT $204DE $79.43
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.