How much rates vary
Facilitymedian $1,318 · 10th to 90th $1,259 to $3,802Professionalmedian $1,349 · 10th to 90th $1,000 to $3,236
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 $831.76 Median $1,000.00 Typical High $1,445.44 | Facility | None | $831.76 | $1,000.00 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,000.00 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $4,677.35 | Facility | None | $2,344.23 | $2,344.23 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $3,981.07 | Professional | None | $1,230.27 | $1,230.27 | $3,981.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $123.03 Median $123.03 Typical High $269.15 | Professional | RR · Rental | $123.03 | $123.03 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $933.25 Median $933.25 Typical High $1,659.59 | Professional | UE · Used equipment | $933.25 | $933.25 | $1,659.59 |
CDPHP Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Facility | None | $1,258.93 | $1,258.93 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Emblem Health Setting Facility Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $8,317.64 | Facility | None | $2,344.23 | $3,801.89 | $8,317.64 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $4,073.80 | Professional | None | $1,513.56 | $2,187.76 | $4,073.80 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,380.38 | $1,905.46 |
MVP Health Care Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,348.96 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $3,311.31 | Facility | None | $1,348.96 | $1,584.89 | $3,311.31 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,380.38 Typical High $1,584.89 | Professional | None | $758.58 | $1,380.38 | $1,584.89 |
Univera Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Facility | None | $1,258.93 | $1,258.93 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,380.38 | $1,905.46 |
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 $489.78 Median $489.78 Typical High $724.44 | Professional | 52 · Reduced service | $489.78 | $489.78 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $288.40 | Professional | 53 · Discontinued | $199.53 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $144.54 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $144.54 |
Where New York sits
The same service costs 3.8 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· 26th of 51
$1,349
HI $3,548DE $933
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.