How much rates vary
Facilitymedian $316 · 10th to 90th $302 to $871Professionalmedian $302 · 10th to 90th $251 to $741
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 $186.21 Median $218.78 Typical High $316.23 | Facility | None | $186.21 | $218.78 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $316.23 | Professional | None | $218.78 | $218.78 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $524.81 Typical High $1,023.29 | Facility | None | $512.86 | $524.81 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $891.25 | Professional | None | $302.00 | $302.00 | $891.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $66.07 | Professional | RR · Rental | $30.20 | $30.20 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $407.38 | Professional | UE · Used equipment | $229.09 | $229.09 | $407.38 |
CDPHP Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Facility | None | $346.74 | $346.74 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Emblem Health Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $1,862.09 | Facility | None | $512.86 | $851.14 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $912.01 | Professional | None | $331.13 | $537.03 | $912.01 |
Excellus BCBS Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $416.87 | Professional | None | $302.00 | $309.03 | $416.87 |
MVP Health Care Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
MVP Health Care Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $741.31 | Professional | None | $302.00 | $302.00 | $741.31 |
United Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $812.83 | Facility | None | $173.78 | $251.19 | $812.83 |
United Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $389.05 | Professional | None | $165.96 | $309.03 | $389.05 |
Univera Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $316.23 | Facility | None | $302.00 | $309.03 | $316.23 |
Univera Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $416.87 | Professional | None | $302.00 | $309.03 | $416.87 |
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 $109.65 Median $109.65 Typical High $158.49 | Professional | 52 · Reduced service | $109.65 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $63.10 | Professional | 53 · Discontinued | $43.65 | $43.65 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $47.86 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $31.62 |
Where New York sits
The same service costs 2.9 times more in Iowa than in Kansas. 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
$302
IA $603KS $209
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.