How much rates vary
Facilitymedian $501 · 10th to 90th $479 to $1,380Professionalmedian $479 · 10th to 90th $363 to $1,175
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 $269.15 Median $346.74 Typical High $501.19 | Facility | None | $269.15 | $346.74 | $501.19 |
Aetna Setting Professional Modifier None (both parts) Typical Low $346.74 Median $346.74 Typical High $501.19 | Professional | None (both parts) | $346.74 | $346.74 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $1,621.81 | Facility | None | $812.83 | $831.76 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $478.63 Median $478.63 Typical High $1,412.54 | Professional | None (both parts) | $478.63 | $478.63 | $1,412.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $104.71 | Professional | RR · Rental | $47.86 | $47.86 | $104.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $645.65 | Professional | UE · Used equipment | $363.08 | $363.08 | $645.65 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None (both parts) | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $549.54 | Facility | None | $489.78 | $489.78 | $549.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None (both parts) | $363.08 | $363.08 | $363.08 |
Emblem Health Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $2,884.03 | Facility | None | $812.83 | $1,318.26 | $2,884.03 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $524.81 Median $851.14 Typical High $1,412.54 | Professional | None (both parts) | $524.81 | $851.14 | $1,412.54 |
Excellus BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $478.63 Median $501.19 Typical High $660.69 | Professional | None (both parts) | $478.63 | $501.19 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $467.74 Median $467.74 Typical High $1,174.90 | Professional | None (both parts) | $467.74 | $467.74 | $1,174.90 |
United Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $1,288.25 | Facility | None | $478.63 | $524.81 | $1,288.25 |
United Setting Professional Modifier None (both parts) Typical Low $263.03 Median $416.87 Typical High $602.56 | Professional | None (both parts) | $263.03 | $416.87 | $602.56 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $501.19 Typical High $501.19 | Facility | None | $478.63 | $501.19 | $501.19 |
Univera Setting Professional Modifier None (both parts) Typical Low $478.63 Median $501.19 Typical High $660.69 | Professional | None (both parts) | $478.63 | $501.19 | $660.69 |
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 $173.78 Median $173.78 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $100.00 | Professional | 53 · Discontinued | $69.18 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $74.13 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $50.12 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $53.70 Typical High $69.18 | Professional | 26 · Professional part | $36.31 | $53.70 | $69.18 |
Where New York sits
The same service costs 3.2 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
$479
HI $1,175DE $363
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.