How much rates vary
Facilitymedian $1,122 · 10th to 90th $724 to $3,236Professionalmedian $1,122 · 10th to 90th $813 to $2,754
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 $691.83 Median $812.83 Typical High $1,174.90 | Facility | None | $691.83 | $812.83 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,174.90 | Professional | None | $812.83 | $812.83 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $3,801.89 | Facility | None | $1,905.46 | $1,949.84 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,122.02 | $3,311.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $245.47 | Professional | RR · Rental | $112.20 | $112.20 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $1,513.56 | Professional | UE · Used equipment | $851.14 | $851.14 | $1,513.56 |
CDPHP Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Facility | None | $1,174.90 | $1,174.90 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Emblem Health Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $6,918.31 | Facility | None | $1,905.46 | $3,162.28 | $6,918.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,230.27 | $2,041.74 | $3,388.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,548.82 | Professional | None | $724.44 | $1,122.02 | $1,548.82 |
MVP Health Care Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
MVP Health Care Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,122.02 | $2,754.23 |
United Setting Facility Modifier None Typical Low $741.31 Median $933.25 Typical High $3,019.95 | Facility | None | $741.31 | $933.25 | $3,019.95 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $1,445.44 | Professional | None | $616.60 | $1,148.15 | $1,445.44 |
Univera Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,122.02 | Facility | None | $724.44 | $724.44 | $1,122.02 |
Univera Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,548.82 | Professional | None | $724.44 | $1,122.02 | $1,548.82 |
5 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 $407.38 Median $407.38 Typical High $588.84 | Professional | 52 · Reduced service | $407.38 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $117.49 |
Highmark BCBS Setting Professional Modifier K3 · Prosthesis level 3 Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | K3 · Prosthesis level 3 | $1,513.56 | $1,513.56 | $1,513.56 |
Where New York sits
The same service costs 3.0 times more in Montana 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· 39th of 51
$1,122
MT $2,512DE $851
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.