How much rates vary
Facilitymedian $347 · 10th to 90th $191 to $977Professionalmedian $339 · 10th to 90th $234 to $832
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 $190.55 Median $245.47 Typical High $354.81 | Facility | None | $190.55 | $245.47 | $354.81 |
Aetna Setting Professional Modifier None (both parts) Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | None (both parts) | $245.47 | $245.47 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $1,148.15 | Facility | None | $575.44 | $575.44 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $338.84 Median $338.84 Typical High $1,000.00 | Professional | None (both parts) | $338.84 | $338.84 | $1,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $33.88 Typical High $74.13 | Professional | RR · Rental | $33.88 | $33.88 | $74.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $257.04 Typical High $457.09 | Professional | UE · Used equipment | $257.04 | $257.04 | $457.09 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None (both parts) | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None (both parts) | $275.42 | $275.42 | $275.42 |
Emblem Health Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $2,041.74 | Facility | None | $575.44 | $933.25 | $2,041.74 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $371.54 Median $575.44 Typical High $1,000.00 | Professional | None (both parts) | $371.54 | $575.44 | $1,000.00 |
Excellus BCBS Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $190.55 Median $338.84 Typical High $467.74 | Professional | None (both parts) | $190.55 | $338.84 | $467.74 |
MVP Health Care Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $331.13 Median $331.13 Typical High $831.76 | Professional | None (both parts) | $331.13 | $331.13 | $831.76 |
United Setting Facility Modifier None Typical Low $269.15 Median $371.54 Typical High $912.01 | Facility | None | $269.15 | $371.54 | $912.01 |
United Setting Professional Modifier None (both parts) Typical Low $186.21 Median $295.12 Typical High $426.58 | Professional | None (both parts) | $186.21 | $295.12 | $426.58 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $338.84 | Facility | None | $190.55 | $190.55 | $338.84 |
Univera Setting Professional Modifier None (both parts) Typical Low $190.55 Median $338.84 Typical High $467.74 | Professional | None (both parts) | $190.55 | $338.84 | $467.74 |
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 $123.03 Median $123.03 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $70.79 | Professional | 53 · Discontinued | $48.98 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $52.48 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $35.48 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $35.48 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $25.70 Median $38.02 Typical High $48.98 | Professional | 26 · Professional part | $25.70 | $38.02 | $48.98 |
Where New York sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 32nd of 51
$339
HI $813VT $275
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.