How much rates vary
Facilitymedian $71 · 10th to 90th $5 to $214Professionalmedian $71 · 10th to 90th $47 to $178
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 $42.66 Median $53.70 Typical High $77.62 | Facility | None | $42.66 | $53.70 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $77.62 | Professional | None | $53.70 | $53.70 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $128.82 Typical High $251.19 | Facility | None | $125.89 | $128.82 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $213.80 | Professional | None | $66.07 | $66.07 | $213.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $14.45 | Professional | RR · Rental | $6.61 | $6.61 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $89.13 | Professional | UE · Used equipment | $50.12 | $50.12 | $89.13 |
CDPHP Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Facility | None | $70.79 | $70.79 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Emblem Health Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $457.09 | Facility | None | $125.89 | $208.93 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $223.87 | Professional | None | $83.18 | $134.90 | $223.87 |
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 $72.44 Typical High $102.33 | Professional | None | $4.57 | $72.44 | $102.33 |
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 $75.86 Median $75.86 Typical High $186.21 | Professional | None | $75.86 | $75.86 | $186.21 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $199.53 | Facility | None | $154.88 | $154.88 | $199.53 |
United Setting Professional Modifier None Typical Low $41.69 Median $66.07 Typical High $89.13 | Professional | None | $41.69 | $66.07 | $89.13 |
Univera Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $72.44 | Facility | None | $4.57 | $4.57 | $72.44 |
Univera Setting Professional Modifier None Typical Low $4.57 Median $72.44 Typical High $102.33 | Professional | None | $4.57 | $72.44 | $102.33 |
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 $26.92 Median $26.92 Typical High $38.90 | Professional | 52 · Reduced service | $26.92 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $15.49 | Professional | 53 · Discontinued | $10.72 | $10.72 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $7.76 |
Where New York sits
The same service costs 2.6 times more in Hawaii 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
$70.79
HI $132DE $51.29
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.