How much rates vary
Facilitymedian $380 · 10th to 90th $363 to $1,023Professionalmedian $363 · 10th to 90th $295 to $891
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 $218.78 Median $263.03 Typical High $380.19 | Facility | None | $218.78 | $263.03 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $380.19 | Professional | None | $263.03 | $263.03 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $1,230.27 | Facility | None | $616.60 | $616.60 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $1,071.52 | Professional | None | $354.81 | $354.81 | $1,071.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $77.62 | Professional | RR · Rental | $35.48 | $35.48 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $263.03 Typical High $478.63 | Professional | UE · Used equipment | $263.03 | $263.03 | $478.63 |
CDPHP Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $537.03 | Facility | None | $501.19 | $501.19 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $2,187.76 | Facility | None | $616.60 | $1,000.00 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,071.52 | Professional | None | $398.11 | $645.65 | $1,071.52 |
Excellus BCBS Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $501.19 | Professional | None | $363.08 | $380.19 | $501.19 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $891.25 | Professional | None | $354.81 | $354.81 | $891.25 |
United Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $954.99 | Facility | None | $229.09 | $288.40 | $954.99 |
United Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $446.68 | Professional | None | $199.53 | $363.08 | $446.68 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $380.19 Typical High $380.19 | Facility | None | $363.08 | $380.19 | $380.19 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $501.19 | Professional | None | $363.08 | $380.19 | $501.19 |
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 $128.82 Median $128.82 Typical High $190.55 | Professional | 52 · Reduced service | $128.82 | $128.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $75.86 | Professional | 53 · Discontinued | $52.48 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $38.02 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $38.02 |
Where New York sits
The same service costs 2.3 times more in Wisconsin than in Florida. 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· 35th of 51
$363
WI $776FL $339
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.