How much rates vary
Facilitymedian $71 · 10th to 90th $52 to $151Professionalmedian $56 · 10th to 90th $42 to $132
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 $30.90 Median $39.81 Typical High $57.54 | Facility | None | $30.90 | $39.81 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $57.54 | Professional | None | $39.81 | $39.81 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $186.21 | Facility | None | $93.33 | $95.50 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $162.18 | Professional | None | $51.29 | $51.29 | $162.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $4.90 Typical High $10.72 | Professional | RR · Rental | $4.90 | $4.90 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $37.15 Typical High $66.07 | Professional | UE · Used equipment | $37.15 | $37.15 | $66.07 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Emblem Health Setting Facility Modifier None Typical Low $93.33 Median $151.36 Typical High $331.13 | Facility | None | $93.33 | $151.36 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $162.18 | Professional | None | $60.26 | $97.72 | $162.18 |
Excellus BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $75.86 | Professional | None | $52.48 | $70.79 | $75.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
MVP Health Care Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
MVP Health Care Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $134.90 | Professional | None | $56.23 | $56.23 | $134.90 |
United Setting Facility Modifier None Typical Low $44.67 Median $112.20 Typical High $147.91 | Facility | None | $44.67 | $112.20 | $147.91 |
United Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $66.07 | Professional | None | $30.20 | $47.86 | $66.07 |
Univera Setting Facility Modifier None Typical Low $52.48 Median $70.79 Typical High $70.79 | Facility | None | $52.48 | $70.79 | $70.79 |
Univera Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $75.86 | Professional | None | $52.48 | $70.79 | $75.86 |
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 $19.95 Median $19.95 Typical High $28.84 | Professional | 52 · Reduced service | $19.95 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $11.48 | Professional | 53 · Discontinued | $7.94 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.51 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.75 |
Where New York sits
The same service costs 2.6 times more in Kansas than in Arizona. 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· 24th of 51
$56.23
KS $107AZ $41.69
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.