How much rates vary
Facilitymedian $417 · 10th to 90th $309 to $912Professionalmedian $324 · 10th to 90th $234 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 $199.53 Median $234.42 Typical High $346.74 | Facility | None | $199.53 | $234.42 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $346.74 | Professional | None | $234.42 | $234.42 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $1,122.02 | Facility | None | $549.54 | $562.34 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $933.25 | Professional | None | $295.12 | $302.00 | $933.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $29.51 Typical High $64.57 | Professional | RR · Rental | $29.51 | $29.51 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $223.87 Typical High $398.11 | Professional | UE · Used equipment | $223.87 | $223.87 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $338.84 | Facility | None | $309.03 | $309.03 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Emblem Health Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $1,995.26 | Facility | None | $549.54 | $912.01 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $977.24 | Professional | None | $363.08 | $588.84 | $977.24 |
Excellus BCBS Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $457.09 | Professional | None | $323.59 | $416.87 | $457.09 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
MVP Health Care Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $812.83 | Professional | None | $323.59 | $323.59 | $812.83 |
United Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $794.33 | Facility | None | $138.04 | $245.47 | $794.33 |
United Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $380.19 | Professional | None | $181.97 | $331.13 | $380.19 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $416.87 Typical High $416.87 | Facility | None | $323.59 | $416.87 | $416.87 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $457.09 | Professional | None | $323.59 | $416.87 | $457.09 |
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 $117.49 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $117.49 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $34.67 |
Where New York sits
The same service costs 2.7 times more in Montana 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· 26th of 51
$324
MT $603DE $224
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.