How much rates vary
Facilitymedian $76 · 10th to 90th $65 to $195Professionalmedian $66 · 10th to 90th $49 to $166
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 $38.90 Median $48.98 Typical High $70.79 | Facility | None | $38.90 | $48.98 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $70.79 | Professional | None | $48.98 | $48.98 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $117.49 Typical High $229.09 | Facility | None | $114.82 | $117.49 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $199.53 | Professional | None | $64.57 | $64.57 | $199.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.31 Median $6.31 Typical High $13.80 | Professional | RR · Rental | $6.31 | $6.31 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $91.20 | Professional | UE · Used equipment | $46.77 | $46.77 | $91.20 |
CDPHP Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $72.44 | Facility | None | $64.57 | $64.57 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Emblem Health Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $416.87 | Facility | None | $114.82 | $190.55 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $204.17 | Professional | None | $74.13 | $120.23 | $204.17 |
Excellus BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $93.33 | Professional | None | $67.61 | $75.86 | $93.33 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $169.82 | Professional | None | $60.26 | $60.26 | $169.82 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $181.97 | Facility | None | $141.25 | $141.25 | $181.97 |
United Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $81.28 | Professional | None | $38.02 | $60.26 | $81.28 |
Univera Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $75.86 | Facility | None | $67.61 | $75.86 | $75.86 |
Univera Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $93.33 | Professional | None | $67.61 | $75.86 | $93.33 |
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 $24.55 Median $24.55 Typical High $35.48 | Professional | 52 · Reduced service | $24.55 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $14.13 | Professional | 53 · Discontinued | $9.77 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $10.72 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $7.08 |
Where New York sits
The same service costs 2.6 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· 23rd of 51
$67.61
HI $120DE $46.77
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.