How much rates vary
Facilitymedian $55 · 10th to 90th $51 to $155Professionalmedian $55 · 10th to 90th $39 to $129
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 $30.90 Median $38.90 Typical High $56.23 | Facility | None | $30.90 | $38.90 | $56.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | None (both parts) | $38.90 | $38.90 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $181.97 | Facility | None | $91.20 | $93.33 | $181.97 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $47.86 Median $47.86 Typical High $154.88 | Professional | None (both parts) | $47.86 | $47.86 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $10.47 | Professional | RR · Rental | $4.79 | $4.79 | $10.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $36.31 Typical High $64.57 | Professional | UE · Used equipment | $36.31 | $36.31 | $64.57 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None (both parts) | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Facility | None | $51.29 | $51.29 | $57.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None (both parts) | $37.15 | $37.15 | $37.15 |
Emblem Health Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $331.13 | Facility | None | $91.20 | $151.36 | $331.13 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $58.88 Median $91.20 Typical High $162.18 | Professional | None (both parts) | $58.88 | $91.20 | $162.18 |
Excellus BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $52.48 Median $54.95 Typical High $74.13 | Professional | None (both parts) | $52.48 | $54.95 | $74.13 |
MVP Health Care Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $134.90 | Professional | None (both parts) | $54.95 | $54.95 | $134.90 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $144.54 | Facility | None | $112.20 | $112.20 | $144.54 |
United Setting Professional Modifier None (both parts) Typical Low $29.51 Median $47.86 Typical High $66.07 | Professional | None (both parts) | $29.51 | $47.86 | $66.07 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $54.95 Typical High $54.95 | Facility | None | $51.29 | $54.95 | $54.95 |
Univera Setting Professional Modifier None (both parts) Typical Low $52.48 Median $54.95 Typical High $74.13 | Professional | None (both parts) | $52.48 | $54.95 | $74.13 |
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 $19.50 Median $19.50 Typical High $28.18 | Professional | 52 · Reduced service | $19.50 | $19.50 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $11.22 | Professional | 53 · Discontinued | $7.76 | $7.76 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.51 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $5.62 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.37 Median $6.46 Typical High $8.32 | Professional | 26 · Professional part | $4.37 | $6.46 | $8.32 |
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· 23rd of 51
$54.95
MT $97.72DE $37.15
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.