How much rates vary
Facilitymedian $1,862 · 10th to 90th $1,549 to $5,370Professionalmedian $1,862 · 10th to 90th $1,549 to $4,571
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 $1,122.02 Median $1,348.96 Typical High $1,949.84 | Facility | None | $1,122.02 | $1,348.96 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,348.96 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $6,309.57 | Facility | None | $3,162.28 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $5,495.41 | Professional | None | $1,862.09 | $1,862.09 | $5,495.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $186.21 Median $186.21 Typical High $407.38 | Professional | RR · Rental | $186.21 | $186.21 | $407.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $1,412.54 Typical High $2,511.89 | Professional | UE · Used equipment | $1,412.54 | $1,412.54 | $2,511.89 |
CDPHP Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,754.23 | Facility | None | $2,570.40 | $2,570.40 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $3,162.28 Median $5,128.61 Typical High $11,220.18 | Facility | None | $3,162.28 | $5,128.61 | $11,220.18 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $5,495.41 | Professional | None | $2,041.74 | $3,388.44 | $5,495.41 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,862.09 | $2,570.40 |
MVP Health Care Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
MVP Health Care Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,570.88 | Professional | None | $1,819.70 | $1,819.70 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $5,011.87 | Facility | None | $1,288.25 | $1,659.59 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,862.09 | $2,344.23 |
Univera Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,548.82 | $1,548.82 | $1,862.09 |
Univera Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,862.09 | $2,570.40 |
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 $660.69 Median $660.69 Typical High $977.24 | Professional | 52 · Reduced service | $660.69 | $660.69 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $389.05 | Professional | 53 · Discontinued | $269.15 | $269.15 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $288.40 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $194.98 |
Where New York sits
The same service costs 2.4 times more in Wisconsin than in Washington, DC. 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· 45th of 51
$1,862
WI $3,981DC $1,660
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.