How much rates vary
Facilitymedian $724 · 10th to 90th $447 to $1,622Professionalmedian $479 · 10th to 90th $417 to $1,259
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 $323.59 Median $416.87 Typical High $602.56 | Facility | None | $323.59 | $416.87 | $602.56 |
Aetna Setting Professional Modifier None (both parts) Typical Low $416.87 Median $416.87 Typical High $602.56 | Professional | None (both parts) | $416.87 | $416.87 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,949.84 | Facility | None | $977.24 | $1,000.00 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $467.74 Median $478.63 Typical High $1,659.59 | Professional | None (both parts) | $467.74 | $478.63 | $1,659.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $46.77 Median $46.77 Typical High $100.00 | Professional | RR · Rental | $46.77 | $46.77 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $630.96 | Professional | UE · Used equipment | $346.74 | $346.74 | $630.96 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None (both parts) | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $501.19 | Facility | None | $446.68 | $446.68 | $501.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None (both parts) | $331.13 | $331.13 | $446.68 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,621.81 Typical High $3,548.13 | Facility | None | $977.24 | $1,621.81 | $3,548.13 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $630.96 Median $977.24 Typical High $1,737.80 | Professional | None (both parts) | $630.96 | $977.24 | $1,737.80 |
Excellus BCBS Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $575.44 Median $724.44 Typical High $794.33 | Professional | None (both parts) | $575.44 | $724.44 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $446.68 Median $446.68 Typical High $1,445.44 | Professional | None (both parts) | $446.68 | $446.68 | $1,445.44 |
United Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $1,174.90 | Facility | None | $478.63 | $630.96 | $1,174.90 |
United Setting Professional Modifier None (both parts) Typical Low $316.23 Median $512.86 Typical High $676.08 | Professional | None (both parts) | $316.23 | $512.86 | $676.08 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $724.44 Typical High $724.44 | Facility | None | $575.44 | $724.44 | $724.44 |
Univera Setting Professional Modifier None (both parts) Typical Low $575.44 Median $724.44 Typical High $794.33 | Professional | None (both parts) | $575.44 | $724.44 | $794.33 |
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 $208.93 Median $208.93 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $208.93 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $91.20 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $60.26 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $64.57 Typical High $85.11 | Professional | 26 · Professional part | $44.67 | $64.57 | $85.11 |
Where New York sits
The same service costs 4.6 times more in Hawaii 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· 20th of 51
$490
HI $1,514DE $331
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.