How much rates vary
Facilitymedian $1,514 · 10th to 90th $1,202 to $3,311Professionalmedian $1,259 · 10th to 90th $955 to $2,951
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 $724.44 Median $870.96 Typical High $1,258.93 | Facility | None | $724.44 | $870.96 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,258.93 | Professional | None | $870.96 | $870.96 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $4,073.80 | Facility | None | $2,041.74 | $2,089.30 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $3,548.13 | Professional | None | $1,122.02 | $1,122.02 | $3,548.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $239.88 | Professional | RR · Rental | $112.20 | $112.20 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $1,479.11 | Professional | UE · Used equipment | $831.76 | $831.76 | $1,479.11 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,412.54 | Facility | None | $1,318.26 | $1,318.26 | $1,412.54 |
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 $2,041.74 Median $3,311.31 Typical High $7,244.36 | Facility | None | $2,041.74 | $3,311.31 | $7,244.36 |
Emblem Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,630.78 | Professional | None | $1,318.26 | $1,905.46 | $3,630.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,513.56 | $1,659.59 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $2,951.21 Typical High $3,388.44 | Professional | None | $1,995.26 | $2,951.21 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,454.71 Typical High $3,235.94 | Facility | None | $1,000.00 | $2,454.71 | $3,235.94 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,202.26 Typical High $1,412.54 | Professional | None | $660.69 | $1,202.26 | $1,412.54 |
Univera Setting Facility Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,202.26 | $1,513.56 | $1,513.56 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,513.56 | $1,659.59 |
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 $436.52 Median $436.52 Typical High $630.96 | Professional | 52 · Reduced service | $436.52 | $436.52 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $251.19 | Professional | 53 · Discontinued | $173.78 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $186.21 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $125.89 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $125.89 |
Where New York sits
The same service costs 3.0 times more in Kansas 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· 28th of 51
$1,259
KS $2,818DE $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.