How much rates vary
Facilitymedian $3,548 · 10th to 90th $3,236 to $8,913Professionalmedian $3,236 · 10th to 90th $2,630 to $7,762
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 $1,949.84 Median $2,344.23 Typical High $3,388.44 | Facility | None | $1,949.84 | $2,344.23 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,388.44 | Professional | None | $2,344.23 | $2,344.23 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $10,964.78 | Facility | None | $5,495.41 | $5,495.41 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $9,549.93 | Professional | None | $2,951.21 | $2,951.21 | $9,549.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $295.12 Median $295.12 Typical High $645.65 | Professional | RR · Rental | $295.12 | $295.12 | $645.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,238.72 Median $2,238.72 Typical High $3,981.07 | Professional | UE · Used equipment | $2,238.72 | $2,238.72 | $3,981.07 |
CDPHP Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,801.89 | Facility | None | $3,548.13 | $3,548.13 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Emblem Health Setting Facility Modifier None Typical Low $5,495.41 Median $8,912.51 Typical High $19,498.45 | Facility | None | $5,495.41 | $8,912.51 | $19,498.45 |
Emblem Health Setting Professional Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $9,549.93 | Professional | None | $3,548.13 | $5,128.61 | $9,549.93 |
Excellus BCBS 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 |
Excellus BCBS Setting Professional Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $4,466.84 | Professional | None | $3,235.94 | $3,311.31 | $4,466.84 |
MVP Health Care Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
MVP Health Care Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $7,943.28 | Professional | None | $3,162.28 | $3,162.28 | $7,943.28 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,365.16 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $3,235.94 Typical High $3,715.35 | Professional | None | $1,778.28 | $3,235.94 | $3,715.35 |
Univera Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,235.94 | $3,311.31 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $4,466.84 | Professional | None | $3,235.94 | $3,311.31 | $4,466.84 |
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 $1,148.15 Median $1,148.15 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $676.08 | Professional | 53 · Discontinued | $467.74 | $467.74 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $501.19 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $338.84 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $338.84 |
Where New York sits
The same service costs 4.3 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· 26th of 51
$3,236
HI $11,220PA $2,630
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.