How much rates vary
Facilitymedian $23 · 10th to 90th $5 to $69Professionalmedian $23 · 10th to 90th $13 to $55
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 $13.80 Median $17.38 Typical High $25.70 | Facility | None | $13.80 | $17.38 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $25.70 | Professional | None | $17.38 | $17.38 | $25.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $41.69 Typical High $83.18 | Facility | None | $40.74 | $41.69 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $69.18 | Professional | None | $13.18 | $13.18 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $10.00 Typical High $21.88 | Professional | UE · Used equipment | $10.00 | $10.00 | $21.88 |
CDPHP Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $25.70 | Facility | None | $22.91 | $22.91 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Emblem Health Setting Facility Modifier None Typical Low $40.74 Median $67.61 Typical High $147.91 | Facility | None | $40.74 | $67.61 | $147.91 |
Emblem Health Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $72.44 | Professional | None | $26.92 | $40.74 | $72.44 |
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 $23.44 Typical High $33.88 | Professional | None | $4.57 | $23.44 | $33.88 |
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 $25.12 Median $25.12 Typical High $60.26 | Professional | None | $25.12 | $25.12 | $60.26 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
United Setting Professional Modifier None Typical Low $13.49 Median $21.38 Typical High $30.20 | Professional | None | $13.49 | $21.38 | $30.20 |
Univera Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $23.44 | Facility | None | $4.57 | $4.57 | $23.44 |
Univera Setting Professional Modifier None Typical Low $4.57 Median $23.44 Typical High $33.88 | Professional | None | $4.57 | $23.44 | $33.88 |
5 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 $8.71 Median $8.71 Typical High $12.59 | Professional | 52 · Reduced service | $8.71 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $5.13 | Professional | 53 · Discontinued | $3.55 | $3.55 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $3.80 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $2.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.74 Median $2.88 Typical High $4.27 | Professional | RR · Rental | $1.74 | $2.88 | $4.27 |
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· 29th of 51
$22.91
MT $43.65DE $16.98
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.