How much rates vary
Facilitymedian $62 · 10th to 90th $56 to $166Professionalmedian $60 · 10th to 90th $42 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 $33.88 Median $44.67 Typical High $60.26 | Facility | None | $33.88 | $44.67 | $60.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $41.69 Typical High $165.96 | Professional | None (both parts) | $41.69 | $41.69 | $165.96 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $77.62 | $77.62 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $194.98 | Facility | None | $97.72 | $100.00 | $194.98 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $57.54 Median $57.54 Typical High $169.82 | Professional | None (both parts) | $57.54 | $57.54 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $13.49 | Professional | RR · Rental | $5.62 | $5.62 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $75.86 | Professional | UE · Used equipment | $42.66 | $42.66 | $75.86 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None (both parts) | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $67.61 | Facility | None | $60.26 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None (both parts) | $44.67 | $44.67 | $44.67 |
Emblem Health Setting Facility Modifier None Typical Low $97.72 Median $162.18 Typical High $354.81 | Facility | None | $97.72 | $162.18 | $354.81 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $63.10 Median $102.33 Typical High $173.78 | Professional | None (both parts) | $63.10 | $102.33 | $173.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $56.23 Median $63.10 Typical High $79.43 | Professional | None (both parts) | $56.23 | $63.10 | $79.43 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $77.62 | $77.62 | $77.62 |
MVP Health Care Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $141.25 | Professional | None (both parts) | $70.79 | $70.79 | $141.25 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $154.88 | Facility | None | $72.44 | $72.44 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $31.62 Median $51.29 Typical High $75.86 | Professional | None (both parts) | $31.62 | $51.29 | $75.86 |
Univera Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Facility | None | $56.23 | $56.23 | $67.61 |
Univera Setting Professional Modifier None (both parts) Typical Low $56.23 Median $63.10 Typical High $79.43 | Professional | None (both parts) | $56.23 | $63.10 | $79.43 |
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 $20.89 Median $20.89 Typical High $30.20 | Professional | 52 · Reduced service | $20.89 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $12.02 | Professional | 53 · Discontinued | $8.32 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $9.12 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $6.03 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $5.25 Median $7.94 Typical High $10.23 | Professional | 26 · Professional part | $5.25 | $7.94 | $10.23 |
Where New York sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 35th of 51
$60.26
WI $100NJ $47.86
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.