How much rates vary
Facilitymedian $54 · 10th to 90th $51 to $148Professionalmedian $51 · 10th to 90th $39 to $123
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 $30.90 Median $37.15 Typical High $54.95 | Facility | None | $30.90 | $37.15 | $54.95 |
Aetna Setting Professional Modifier None (both parts) Typical Low $37.15 Median $37.15 Typical High $54.95 | Professional | None (both parts) | $37.15 | $37.15 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $89.13 Typical High $177.83 | Facility | None | $87.10 | $89.13 | $177.83 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $147.91 | Professional | None (both parts) | $50.12 | $50.12 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $11.75 | Professional | RR · Rental | $5.01 | $5.01 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $67.61 | Professional | UE · Used equipment | $38.02 | $38.02 | $67.61 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None (both parts) | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $60.26 | Facility | None | $53.70 | $53.70 | $60.26 |
Cigna Setting Professional Modifier None (both parts) Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None (both parts) | $38.90 | $38.90 | $38.90 |
Emblem Health Setting Facility Modifier None Typical Low $87.10 Median $144.54 Typical High $316.23 | Facility | None | $87.10 | $144.54 | $316.23 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $57.54 Median $87.10 Typical High $154.88 | Professional | None (both parts) | $57.54 | $87.10 | $154.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $51.29 Median $54.95 Typical High $72.44 | Professional | None (both parts) | $51.29 | $54.95 | $72.44 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $128.82 | Professional | None (both parts) | $42.66 | $42.66 | $128.82 |
United Setting Facility Modifier None Typical Low $16.98 Median $39.81 Typical High $141.25 | Facility | None | $16.98 | $39.81 | $141.25 |
United Setting Professional Modifier None (both parts) Typical Low $28.84 Median $45.71 Typical High $67.61 | Professional | None (both parts) | $28.84 | $45.71 | $67.61 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $54.95 | Facility | None | $51.29 | $51.29 | $54.95 |
Univera Setting Professional Modifier None (both parts) Typical Low $51.29 Median $54.95 Typical High $72.44 | Professional | None (both parts) | $51.29 | $54.95 | $72.44 |
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 $18.62 Median $18.62 Typical High $26.92 | Professional | 52 · Reduced service | $18.62 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $10.96 | Professional | 53 · Discontinued | $7.59 | $7.59 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $5.37 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $4.27 Median $4.79 Typical High $6.31 | Professional | 26 · Professional part | $4.27 | $4.79 | $6.31 |
Where New York sits
The same service costs 3.3 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· 34th of 51
$51.29
HI $135DE $40.74
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.