How much rates vary
Facilitymedian $71 · 10th to 90th $68 to $191Professionalmedian $68 · 10th to 90th $51 to $158
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 $39.81 Median $48.98 Typical High $70.79 | Facility | None | $39.81 | $48.98 | $70.79 |
Aetna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $70.79 | Professional | None (both parts) | $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 (both parts) Typical Low $67.61 Median $67.61 Typical High $199.53 | Professional | None (both parts) | $67.61 | $67.61 | $199.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $14.79 | Professional | RR · Rental | $6.61 | $6.61 | $14.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $89.13 | Professional | UE · Used equipment | $50.12 | $50.12 | $89.13 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None (both parts) | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $77.62 | Facility | None | $70.79 | $70.79 | $77.62 |
Cigna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None (both parts) | $51.29 | $51.29 | $51.29 |
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 (both parts) Typical Low $74.13 Median $120.23 Typical High $204.17 | Professional | None (both parts) | $74.13 | $120.23 | $204.17 |
Excellus BCBS Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $67.61 Median $70.79 Typical High $93.33 | Professional | None (both parts) | $67.61 | $70.79 | $93.33 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None (both parts) | $91.20 | $91.20 | $91.20 |
MVP Health Care Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $169.82 | Professional | None (both parts) | $51.29 | $51.29 | $169.82 |
United Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $169.82 | Facility | None | $57.54 | $63.10 | $169.82 |
United Setting Professional Modifier None (both parts) Typical Low $38.02 Median $60.26 Typical High $85.11 | Professional | None (both parts) | $38.02 | $60.26 | $85.11 |
Univera Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Facility | None | $67.61 | $67.61 | $70.79 |
Univera Setting Professional Modifier None (both parts) Typical Low $67.61 Median $70.79 Typical High $93.33 | Professional | None (both parts) | $67.61 | $70.79 | $93.33 |
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 $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 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.90 Median $5.89 Typical High $7.59 | Professional | 26 · Professional part | $4.90 | $5.89 | $7.59 |
Where New York sits
The same service costs 2.4 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· 27th of 51
$67.61
MT $123DE $51.29
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.