How much rates vary
Facilitymedian $25 · 10th to 90th $20 to $60Professionalmedian $21 · 10th to 90th $15 to $49
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 $11.75 Median $15.14 Typical High $21.88 | Facility | None | $11.75 | $15.14 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $21.88 | Professional | None | $15.14 | $15.14 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $70.79 | Facility | None | $35.48 | $35.48 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $60.26 | Professional | None | $18.62 | $18.62 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $3.98 | Professional | RR · Rental | $1.82 | $1.82 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $13.80 Typical High $24.55 | Professional | UE · Used equipment | $13.80 | $13.80 | $24.55 |
CDPHP Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Facility | None | $24.55 | $24.55 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Emblem Health Setting Facility Modifier None Typical Low $35.48 Median $57.54 Typical High $125.89 | Facility | None | $35.48 | $57.54 | $125.89 |
Emblem Health Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $61.66 | Professional | None | $22.91 | $35.48 | $61.66 |
Excellus BCBS Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Excellus BCBS Setting Professional Modifier None Typical Low $19.95 Median $24.55 Typical High $28.84 | Professional | None | $19.95 | $24.55 | $28.84 |
Fidelis Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
MVP Health Care Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
MVP Health Care Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $51.29 | Professional | None | $21.38 | $21.38 | $51.29 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $56.23 | Facility | None | $42.66 | $42.66 | $56.23 |
United Setting Professional Modifier None Typical Low $11.48 Median $18.20 Typical High $25.70 | Professional | None | $11.48 | $18.20 | $25.70 |
Univera Setting Facility Modifier None Typical Low $19.50 Median $24.55 Typical High $24.55 | Facility | None | $19.50 | $24.55 | $24.55 |
Univera Setting Professional Modifier None Typical Low $19.95 Median $24.55 Typical High $28.84 | Professional | None | $19.95 | $24.55 | $28.84 |
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 $7.41 Median $7.41 Typical High $10.96 | Professional | 52 · Reduced service | $7.41 | $7.41 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $4.37 | Professional | 53 · Discontinued | $3.02 | $3.02 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $3.24 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $2.19 |
Where New York sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$21.38
MT $37.15WV $17.78
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.