How much rates vary
Facilitymedian $1,778 · 10th to 90th $1,288 to $3,631Professionalmedian $1,318 · 10th to 90th $955 to $2,884
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 $2,137.96 Typical High $4,265.80 | Facility | None | $2,137.96 | $2,137.96 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $3,548.13 | Professional | None | $1,288.25 | $1,318.26 | $3,548.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $128.82 Median $128.82 Typical High $281.84 | Professional | RR · Rental | $128.82 | $128.82 | $281.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $954.99 Median $954.99 Typical High $1,737.80 | Professional | UE · Used equipment | $954.99 | $954.99 | $1,737.80 |
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 $1,288.25 Median $1,288.25 Typical High $1,445.44 | Facility | None | $1,288.25 | $1,288.25 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Emblem Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $7,585.78 | Facility | None | $2,137.96 | $3,467.37 | $7,585.78 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,380.38 | $2,238.72 | $3,715.35 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,737.80 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
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 $1,348.96 Median $1,380.38 Typical High $3,388.44 | Facility | None | $1,348.96 | $1,380.38 | $3,388.44 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $1,584.89 | Professional | None | $691.83 | $1,258.93 | $1,584.89 |
Univera Setting Facility Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,258.93 | $1,778.28 | $1,778.28 |
Univera Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,737.80 | $1,778.28 |
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 $446.68 Median $446.68 Typical High $660.69 | Professional | 52 · Reduced service | $446.68 | $446.68 | $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 $194.98 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $194.98 |
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 3.4 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· 27th of 51
$1,318
HI $3,236DE $955
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.