How much rates vary
Facilitymedian $66 · 10th to 90th $52 to $204Professionalmedian $69 · 10th to 90th $51 to $170
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 $41.69 Median $52.48 Typical High $75.86 | Facility | None | $41.69 | $52.48 | $75.86 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $52.48 Typical High $75.86 | Professional | None (both parts) | $52.48 | $52.48 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $245.47 | Facility | None | $123.03 | $125.89 | $245.47 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $61.66 Median $61.66 Typical High $208.93 | Professional | None (both parts) | $61.66 | $61.66 | $208.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $13.49 | Professional | RR · Rental | $6.17 | $6.17 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $83.18 | Professional | UE · Used equipment | $46.77 | $46.77 | $83.18 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Cigna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $48.98 | $48.98 | $48.98 |
Emblem Health Setting Facility Modifier None Typical Low $123.03 Median $204.17 Typical High $446.68 | Facility | None | $123.03 | $204.17 | $446.68 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $79.43 Median $128.82 Typical High $218.78 | Professional | None (both parts) | $79.43 | $128.82 | $218.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $52.48 Median $72.44 Typical High $100.00 | Professional | None (both parts) | $52.48 | $72.44 | $100.00 |
MVP Health Care Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $181.97 | Professional | None (both parts) | $72.44 | $72.44 | $181.97 |
United Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $165.96 | Facility | None | $46.77 | $61.66 | $165.96 |
United Setting Professional Modifier None (both parts) Typical Low $39.81 Median $64.57 Typical High $87.10 | Professional | None (both parts) | $39.81 | $64.57 | $87.10 |
Univera Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Facility | None | $52.48 | $52.48 | $72.44 |
Univera Setting Professional Modifier None (both parts) Typical Low $52.48 Median $72.44 Typical High $100.00 | Professional | None (both parts) | $52.48 | $72.44 | $100.00 |
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 $26.30 Median $26.30 Typical High $38.02 | Professional | 52 · Reduced service | $26.30 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $15.14 | Professional | 53 · Discontinued | $10.47 | $10.47 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $11.48 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $7.59 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $5.62 Median $8.13 Typical High $10.72 | Professional | 26 · Professional part | $5.62 | $8.13 | $10.72 |
Where New York sits
The same service costs 2.7 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· 21st of 51
$69.18
HI $132DE $48.98
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.