How much rates vary
Facilitymedian $65 · 10th to 90th $46 to $182Professionalmedian $62 · 10th to 90th $46 to $145
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 $35.48 Median $45.71 Typical High $66.07 | Facility | None | $35.48 | $45.71 | $66.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | None (both parts) | $45.71 | $45.71 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $213.80 | Facility | None | $107.15 | $109.65 | $213.80 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $61.66 Median $63.10 Typical High $181.97 | Professional | None (both parts) | $61.66 | $63.10 | $181.97 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $13.18 | Professional | RR · Rental | $6.17 | $6.17 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $83.18 | Professional | UE · Used equipment | $45.71 | $45.71 | $83.18 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None (both parts) | $87.10 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $48.98 | $48.98 | $48.98 |
Emblem Health Setting Facility Modifier None Typical Low $107.15 Median $177.83 Typical High $389.05 | Facility | None | $107.15 | $177.83 | $389.05 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $69.18 Median $107.15 Typical High $190.55 | Professional | None (both parts) | $69.18 | $107.15 | $190.55 |
Excellus BCBS Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $45.71 Median $60.26 Typical High $87.10 | Professional | None (both parts) | $45.71 | $60.26 | $87.10 |
MVP Health Care Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $61.66 Median $61.66 Typical High $154.88 | Professional | None (both parts) | $61.66 | $61.66 | $154.88 |
United Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $169.82 | Facility | None | $61.66 | $69.18 | $169.82 |
United Setting Professional Modifier None (both parts) Typical Low $34.67 Median $54.95 Typical High $79.43 | Professional | None (both parts) | $34.67 | $54.95 | $79.43 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $60.26 | Facility | None | $45.71 | $45.71 | $60.26 |
Univera Setting Professional Modifier None (both parts) Typical Low $45.71 Median $60.26 Typical High $87.10 | Professional | None (both parts) | $45.71 | $60.26 | $87.10 |
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 $22.91 Median $22.91 Typical High $33.11 | Professional | 52 · Reduced service | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $13.18 | Professional | 53 · Discontinued | $9.12 | $9.12 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $10.00 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.61 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.79 Median $7.08 Typical High $9.12 | Professional | 26 · Professional part | $4.79 | $7.08 | $9.12 |
Where New York sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 37th of 51
$61.66
HI $174FL $48.98
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.