How much rates vary
Facilitymedian $955 · 10th to 90th $646 to $2,692Professionalmedian $1,023 · 10th to 90th $676 to $2,455
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 $562.34 Median $676.08 Typical High $977.24 | Facility | None | $562.34 | $676.08 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $977.24 | Professional | None | $676.08 | $676.08 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $1,621.81 Typical High $3,162.28 | Facility | None | $1,584.89 | $1,621.81 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,445.44 | $3,090.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $144.54 Median $144.54 Typical High $346.74 | Professional | RR · Rental | $144.54 | $144.54 | $346.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,096.48 Median $1,096.48 Typical High $1,949.84 | Professional | UE · Used equipment | $1,096.48 | $1,096.48 | $1,949.84 |
CDPHP Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Facility | None | $954.99 | $954.99 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $5,623.41 | Facility | None | $1,584.89 | $2,570.40 | $5,623.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,023.29 | $1,479.11 | $2,754.23 |
Excellus BCBS Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Excellus BCBS Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,288.25 | Professional | None | $645.65 | $933.25 | $1,288.25 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
MVP Health Care Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $2,290.87 | Professional | None | $912.01 | $912.01 | $2,290.87 |
United Setting Facility Modifier None Typical Low $173.78 Median $1,023.29 Typical High $2,511.89 | Facility | None | $173.78 | $1,023.29 | $2,511.89 |
United Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $1,174.90 | Professional | None | $512.86 | $933.25 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $933.25 | Facility | None | $645.65 | $645.65 | $933.25 |
Univera Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,288.25 | Professional | None | $645.65 | $933.25 | $1,288.25 |
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 $338.84 Median $338.84 Typical High $489.78 | Professional | 52 · Reduced service | $338.84 | $338.84 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | 53 · Discontinued | $134.90 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $144.54 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $97.72 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $97.72 |
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· 29th of 51
$1,023
HI $2,239DE $708
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.