How much rates vary
Facilitymedian $19 · 10th to 90th $16 to $47Professionalmedian $17 · 10th to 90th $12 to $41
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 $9.33 Median $12.02 Typical High $17.38 | Facility | None | $9.33 | $12.02 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $17.38 | Professional | None | $12.02 | $12.02 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $28.84 Typical High $56.23 | Facility | None | $28.18 | $28.84 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $48.98 | Professional | None | $15.49 | $15.49 | $48.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $1.55 Typical High $3.39 | Professional | RR · Rental | $1.55 | $1.55 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.48 Median $11.48 Typical High $20.89 | Professional | UE · Used equipment | $11.48 | $11.48 | $20.89 |
CDPHP Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $17.38 | Facility | None | $15.85 | $15.85 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Emblem Health Setting Facility Modifier None Typical Low $28.18 Median $46.77 Typical High $102.33 | Facility | None | $28.18 | $46.77 | $102.33 |
Emblem Health Setting Professional Modifier None Typical Low $18.20 Median $29.51 Typical High $50.12 | Professional | None | $18.20 | $29.51 | $50.12 |
Excellus BCBS Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $22.91 | Professional | None | $16.60 | $19.50 | $22.91 |
MVP Health Care Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
MVP Health Care Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $41.69 | Professional | None | $16.98 | $16.98 | $41.69 |
United Setting Facility Modifier None Typical Low $13.49 Median $34.67 Typical High $44.67 | Facility | None | $13.49 | $34.67 | $44.67 |
United Setting Professional Modifier None Typical Low $9.12 Median $14.79 Typical High $20.42 | Professional | None | $9.12 | $14.79 | $20.42 |
Univera Setting Facility Modifier None Typical Low $16.60 Median $19.50 Typical High $19.50 | Facility | None | $16.60 | $19.50 | $19.50 |
Univera Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $22.91 | Professional | None | $16.60 | $19.50 | $22.91 |
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 $6.03 Median $6.03 Typical High $8.71 | Professional | 52 · Reduced service | $6.03 | $6.03 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $3.47 | Professional | 53 · Discontinued | $2.40 | $2.40 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $2.63 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.74 |
Where New York sits
The same service costs 5.5 times more in Kansas 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· 23rd of 51
$16.98
KS $63.10DE $11.48
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.