How much rates vary
Facilitymedian $78 · 10th to 90th $59 to $204Professionalmedian $63 · 10th to 90th $44 to $166
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 $34.67 Median $43.65 Typical High $63.10 | Facility | None | $34.67 | $43.65 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $173.78 | Professional | None | $43.65 | $43.65 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $104.71 Typical High $204.17 | Facility | None | $102.33 | $104.71 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $186.21 | Professional | None | $63.10 | $63.10 | $186.21 |
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 $45.71 Median $45.71 Typical High $83.18 | Professional | UE · Used equipment | $45.71 | $45.71 | $83.18 |
CDPHP Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Facility | None | $67.61 | $67.61 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $169.82 Typical High $371.54 | Facility | None | $102.33 | $169.82 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $181.97 | Professional | None | $66.07 | $112.20 | $181.97 |
Excellus BCBS Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $83.18 | Professional | None | $57.54 | $61.66 | $83.18 |
Highmark BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
MVP Health Care Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $151.36 | Professional | None | $52.48 | $52.48 | $151.36 |
United Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $165.96 | Facility | None | $67.61 | $77.62 | $165.96 |
United Setting Professional Modifier None Typical Low $33.88 Median $53.70 Typical High $77.62 | Professional | None | $33.88 | $53.70 | $77.62 |
Univera Setting Facility Modifier None Typical Low $57.54 Median $58.88 Typical High $63.10 | Facility | None | $57.54 | $58.88 | $63.10 |
Univera Setting Professional Modifier None Typical Low $34.67 Median $61.66 Typical High $83.18 | Professional | None | $34.67 | $61.66 | $83.18 |
4 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 $21.88 Median $21.88 Typical High $31.62 | Professional | 52 · Reduced service | $21.88 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $12.59 | Professional | 53 · Discontinued | $8.71 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $9.55 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $6.31 |
Where New York sits
The same service costs 4.1 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· 35th of 51
$63.10
HI $209DE $51.29
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.