How much rates vary
Facilitymedian $1,202 · 10th to 90th $912 to $3,162Professionalmedian $1,122 · 10th to 90th $912 to $2,692
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 $676.08 Median $794.33 Typical High $1,148.15 | Facility | None | $676.08 | $794.33 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,148.15 | Professional | None | $794.33 | $794.33 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $3,715.35 | Facility | None | $1,862.09 | $1,905.46 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,122.02 | $3,311.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $245.47 | Professional | RR · Rental | $112.20 | $112.20 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $1,513.56 | Professional | UE · Used equipment | $831.76 | $831.76 | $1,513.56 |
CDPHP Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,698.24 | Facility | None | $1,584.89 | $1,584.89 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Emblem Health Setting Facility Modifier None Typical Low $1,862.09 Median $3,090.30 Typical High $6,760.83 | Facility | None | $1,862.09 | $3,090.30 | $6,760.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,862.09 | $3,311.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,513.56 | Professional | None | $912.01 | $1,096.48 | $1,513.56 |
MVP Health Care Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
MVP Health Care Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,691.53 | Professional | None | $1,096.48 | $1,096.48 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $2,951.21 | Facility | None | $1,202.26 | $1,258.93 | $2,951.21 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,412.54 | Professional | None | $602.56 | $1,122.02 | $1,412.54 |
Univera Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Facility | None | $912.01 | $912.01 | $1,096.48 |
Univera Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,513.56 | Professional | None | $912.01 | $1,096.48 | $1,513.56 |
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 $398.11 Median $398.11 Typical High $575.44 | Professional | 52 · Reduced service | $398.11 | $398.11 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $173.78 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $114.82 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $114.82 |
Where New York sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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· 47th of 51
$1,122
HI $2,692DC $977
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.