How much rates vary
Facilitymedian $158 · 10th to 90th $141 to $468Professionalmedian $162 · 10th to 90th $117 to $398
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 $95.50 Median $141.25 Typical High $169.82 | Facility | None | $95.50 | $141.25 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $457.09 | Professional | None | $117.49 | $117.49 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $549.54 | Facility | None | $275.42 | $275.42 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $467.74 | Professional | None | $158.49 | $158.49 | $467.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $34.67 | Professional | RR · Rental | $15.85 | $15.85 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $208.93 | Professional | UE · Used equipment | $117.49 | $117.49 | $208.93 |
CDPHP Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $158.49 | Facility | None | $141.25 | $141.25 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $977.24 | Facility | None | $275.42 | $446.68 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $478.63 | Professional | None | $177.83 | $288.40 | $478.63 |
Excellus BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $223.87 | Professional | None | $158.49 | $169.82 | $223.87 |
Fidelis Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $158.49 | Professional | None | $107.15 | $107.15 | $158.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
MVP Health Care Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
MVP Health Care Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $398.11 | Professional | None | $165.96 | $165.96 | $398.11 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Facility | None | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $199.53 | Professional | None | $89.13 | $141.25 | $199.53 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $169.82 | Facility | None | $158.49 | $158.49 | $169.82 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $223.87 | Professional | None | $158.49 | $169.82 | $223.87 |
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 $58.88 Median $58.88 Typical High $85.11 | Professional | 52 · Reduced service | $58.88 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $33.88 | Professional | 53 · Discontinued | $23.44 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $16.98 |
Where New York sits
The same service costs 2.2 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· 30th of 51
$162
HI $275DE $126
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.