How much rates vary
Facilitymedian $1,318 · 10th to 90th $891 to $3,631Professionalmedian $1,288 · 10th to 90th $912 to $3,090
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 $758.58 Median $912.01 Typical High $1,318.26 | Facility | None | $758.58 | $912.01 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,318.26 | Professional | None | $912.01 | $912.01 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $4,265.80 | Facility | None | $2,137.96 | $2,187.76 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,288.25 | $3,715.35 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $128.82 Median $128.82 Typical High $275.42 | Professional | RR · Rental | $128.82 | $128.82 | $275.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $954.99 Median $954.99 Typical High $1,698.24 | Professional | UE · Used equipment | $954.99 | $954.99 | $1,698.24 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,737.80 | Facility | None | $1,621.81 | $1,621.81 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Emblem Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,548.13 Typical High $7,762.47 | Facility | None | $2,137.96 | $3,548.13 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,380.38 | $2,238.72 | $3,801.89 |
Excellus BCBS Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $891.25 | $1,258.93 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
MVP Health Care Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $3,090.30 | Professional | None | $1,230.27 | $1,230.27 | $3,090.30 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,380.38 Typical High $3,388.44 | Facility | None | $776.25 | $1,380.38 | $3,388.44 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $1,621.81 | Professional | None | $691.83 | $1,288.25 | $1,621.81 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,258.93 | Facility | None | $891.25 | $891.25 | $1,258.93 |
Univera Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $891.25 | $1,258.93 | $1,737.80 |
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 $457.09 Median $457.09 Typical High $660.69 | Professional | 52 · Reduced service | $457.09 | $457.09 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $263.03 | Professional | 53 · Discontinued | $181.97 | $181.97 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $199.53 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $131.83 |
Where New York sits
The same service costs 2.7 times more in Hawaii than in Pennsylvania. 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· 34th of 51
$1,288
HI $3,020PA $1,122
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.