How much rates vary
Facilitymedian $871 · 10th to 90th $603 to $2,884Professionalmedian $1,000 · 10th to 90th $631 to $2,399
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 $630.96 Median $741.31 Typical High $1,071.52 | Facility | None | $630.96 | $741.31 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,071.52 | Professional | None | $741.31 | $741.31 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,467.37 | Facility | None | $1,737.80 | $1,778.28 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,951.21 | Professional | None | $812.83 | $812.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $177.83 | Professional | RR · Rental | $81.28 | $81.28 | $177.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $1,096.48 | Professional | UE · Used equipment | $616.60 | $616.60 | $1,096.48 |
CDPHP Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $6,309.57 | Facility | None | $1,737.80 | $2,884.03 | $6,309.57 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,819.70 | $3,090.30 |
Excellus BCBS Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,412.54 | Professional | None | $602.56 | $1,023.29 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
MVP Health Care Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,023.29 | $2,570.40 |
United Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $2,187.76 | Facility | None | $891.25 | $1,513.56 | $2,187.76 |
United Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,174.90 | Professional | None | $575.44 | $1,000.00 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $1,023.29 | Facility | None | $602.56 | $602.56 | $1,023.29 |
Univera Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,412.54 | Professional | None | $602.56 | $1,023.29 | $1,412.54 |
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 $371.54 Median $371.54 Typical High $537.03 | Professional | 52 · Reduced service | $371.54 | $371.54 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | 53 · Discontinued | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $107.15 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $107.15 |
Where New York sits
The same service costs 4.0 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· 21st of 51
$1,000
HI $2,512DE $631
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.