How much rates vary
Facilitymedian $1,660 · 10th to 90th $1,318 to $3,802Professionalmedian $1,349 · 10th to 90th $1,072 to $3,020
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 $794.33 Median $954.99 Typical High $1,380.38 | Facility | None | $794.33 | $954.99 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,380.38 | Professional | None | $954.99 | $954.99 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $4,466.84 | Facility | None | $2,238.72 | $2,238.72 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $3,715.35 | Professional | None | $1,318.26 | $1,348.96 | $3,715.35 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $131.83 Median $131.83 Typical High $288.40 | Professional | RR · Rental | $131.83 | $131.83 | $288.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $977.24 Median $977.24 Typical High $1,778.28 | Professional | UE · Used equipment | $977.24 | $977.24 | $1,778.28 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,778.28 | Facility | None | $1,584.89 | $1,584.89 | $1,778.28 |
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 $2,238.72 Median $3,630.78 Typical High $7,943.28 | Facility | None | $2,238.72 | $3,630.78 | $7,943.28 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,445.44 | $2,344.23 | $3,890.45 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,659.59 | $1,819.70 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,288.25 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $3,548.13 | Facility | None | $1,258.93 | $1,445.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,318.26 Typical High $1,659.59 | Professional | None | $724.44 | $1,318.26 | $1,659.59 |
Univera Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,318.26 | $1,659.59 | $1,659.59 |
Univera Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,659.59 | $1,819.70 |
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 $467.74 Median $467.74 Typical High $691.83 | Professional | 52 · Reduced service | $467.74 | $467.74 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $275.42 | Professional | 53 · Discontinued | $190.55 | $190.55 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $204.17 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $138.04 |
Where New York sits
The same service costs 2.7 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· 33rd of 51
$1,349
HI $3,162DE $1,175
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.