How much rates vary
Facilitymedian $126 · 10th to 90th $117 to $363Professionalmedian $120 · 10th to 90th $93 to $282
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 $69.18 Median $85.11 Typical High $123.03 | Facility | None | $69.18 | $85.11 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $123.03 | Professional | None | $85.11 | $85.11 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $162.18 | Professional | None | $104.71 | $104.71 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $398.11 | Facility | None | $199.53 | $204.17 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $346.74 | Professional | None | $120.23 | $120.23 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $25.70 | Professional | RR · Rental | $11.48 | $11.48 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $154.88 | Professional | UE · Used equipment | $87.10 | $87.10 | $154.88 |
CDPHP Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $141.25 | Facility | None | $107.15 | $125.89 | $141.25 |
Cigna Setting Facility Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | RR · Rental | $12.59 | $12.59 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Emblem Health Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $724.44 | Facility | None | $199.53 | $331.13 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $354.81 | Professional | None | $131.83 | $208.93 | $354.81 |
Excellus BCBS Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
Fidelis Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Highmark BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
MVP Health Care Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $295.12 | Professional | None | $123.03 | $123.03 | $295.12 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $316.23 | Facility | None | $245.47 | $245.47 | $316.23 |
United Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $147.91 | Professional | None | $66.07 | $104.71 | $147.91 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Univera Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
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 $42.66 Median $42.66 Typical High $61.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $25.12 | Professional | 53 · Discontinued | $16.98 | $16.98 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $18.62 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $12.30 |
Where New York sits
The same service costs 2.1 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· 32nd of 51
$120
HI $200DE $93.33
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.