How much rates vary
Facilitymedian $35 · 10th to 90th $29 to $85Professionalmedian $30 · 10th to 90th $22 to $72
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 $16.98 Median $21.38 Typical High $30.90 | Facility | None | $16.98 | $21.38 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $30.90 | Professional | None | $21.38 | $21.38 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $100.00 | Facility | None | $50.12 | $51.29 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $87.10 | Professional | None | $27.54 | $27.54 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $6.03 | Professional | RR · Rental | $2.75 | $2.75 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $40.74 | Professional | UE · Used equipment | $20.42 | $20.42 | $40.74 |
CDPHP Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $83.18 Typical High $181.97 | Facility | None | $50.12 | $83.18 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $32.36 Median $52.48 Typical High $89.13 | Professional | None | $32.36 | $52.48 | $89.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Excellus BCBS Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $40.74 | Professional | None | $28.84 | $34.67 | $40.74 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
MVP Health Care Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $74.13 | Professional | None | $30.20 | $30.20 | $74.13 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $79.43 | Facility | None | $61.66 | $61.66 | $79.43 |
United Setting Professional Modifier None Typical Low $16.60 Median $26.30 Typical High $36.31 | Professional | None | $16.60 | $26.30 | $36.31 |
Univera Setting Facility Modifier None Typical Low $28.18 Median $34.67 Typical High $34.67 | Facility | None | $28.18 | $34.67 | $34.67 |
Univera Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $40.74 | Professional | None | $28.84 | $34.67 | $40.74 |
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 $10.72 Median $10.72 Typical High $15.49 | Professional | 52 · Reduced service | $10.72 | $10.72 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $6.17 | Professional | 53 · Discontinued | $4.27 | $4.27 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $4.68 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $3.09 |
Where New York sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$30.20
MT $53.70AZ $24.55
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.