How much rates vary
Facilitymedian $912 · 10th to 90th $708 to $2,512Professionalmedian $871 · 10th to 90th $661 to $1,995
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 $524.81 Median $630.96 Typical High $912.01 | Facility | None | $524.81 | $630.96 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $912.01 | Professional | None | $630.96 | $630.96 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $2,951.21 | Facility | None | $1,479.11 | $1,513.56 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $2,511.89 | Professional | None | $870.96 | $912.01 | $2,511.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $87.10 Median $87.10 Typical High $190.55 | Professional | RR · Rental | $87.10 | $87.10 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $660.69 Median $660.69 Typical High $1,174.90 | Professional | UE · Used equipment | $660.69 | $660.69 | $1,174.90 |
CDPHP Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $977.24 | Facility | None | $912.01 | $912.01 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $5,370.32 | Facility | None | $1,479.11 | $2,454.71 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $2,630.27 | Professional | None | $954.99 | $1,479.11 | $2,630.27 |
Excellus BCBS Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,202.26 | Professional | None | $707.95 | $870.96 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
MVP Health Care Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $2,137.96 | Professional | None | $851.14 | $851.14 | $2,137.96 |
United Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $2,344.23 | Facility | None | $812.83 | $954.99 | $2,344.23 |
United Setting Professional Modifier None Typical Low $478.63 Median $891.25 Typical High $1,122.02 | Professional | None | $478.63 | $891.25 | $1,122.02 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $870.96 | Facility | None | $707.95 | $707.95 | $870.96 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,202.26 | Professional | None | $707.95 | $870.96 | $1,202.26 |
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 $316.23 Median $316.23 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $316.23 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | 53 · Discontinued | $125.89 | $125.89 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $91.20 |
Where New York sits
The same service costs 3.2 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· 37th of 51
$871
HI $2,138DE $661
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.