How much rates vary
Facilitymedian $44 · 10th to 90th $13 to $132Professionalmedian $44 · 10th to 90th $30 to $112
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 $25.70 Median $33.11 Typical High $47.86 | Facility | None | $25.70 | $33.11 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | None | $33.11 | $33.11 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $154.88 | Facility | None | $77.62 | $79.43 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $134.90 | Professional | None | $42.66 | $42.66 | $134.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $9.33 | Professional | RR · Rental | $4.27 | $4.27 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | UE · Used equipment | $31.62 | $31.62 | $57.54 |
CDPHP Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $47.86 | Facility | None | $43.65 | $43.65 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Emblem Health Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $281.84 | Facility | None | $77.62 | $128.82 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $50.12 Median $81.28 Typical High $138.04 | Professional | None | $50.12 | $81.28 | $138.04 |
Excellus BCBS Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $13.18 Median $44.67 Typical High $63.10 | Professional | None | $13.18 | $44.67 | $63.10 |
MVP Health Care Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $114.82 | Professional | None | $46.77 | $46.77 | $114.82 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $123.03 | Facility | None | $95.50 | $95.50 | $123.03 |
United Setting Professional Modifier None Typical Low $25.12 Median $40.74 Typical High $57.54 | Professional | None | $25.12 | $40.74 | $57.54 |
Univera Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $44.67 | Facility | None | $13.18 | $13.18 | $44.67 |
Univera Setting Professional Modifier None Typical Low $13.18 Median $44.67 Typical High $63.10 | Professional | None | $13.18 | $44.67 | $63.10 |
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 $16.60 Median $16.60 Typical High $23.99 | Professional | 52 · Reduced service | $16.60 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $9.55 | Professional | 53 · Discontinued | $6.61 | $6.61 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $7.24 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $4.79 |
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
$43.65
MT $83.18DE $31.62
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.