How much rates vary
Facilitymedian $372 · 10th to 90th $316 to $912Professionalmedian $324 · 10th to 90th $245 to $724
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 $190.55 Median $229.09 Typical High $331.13 | Facility | None | $190.55 | $229.09 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $331.13 | Professional | None | $229.09 | $229.09 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $549.54 Typical High $1,071.52 | Facility | None | $537.03 | $549.54 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $912.01 | Professional | None | $316.23 | $323.59 | $912.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $31.62 Median $31.62 Typical High $69.18 | Professional | RR · Rental | $31.62 | $31.62 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $426.58 | Professional | UE · Used equipment | $239.88 | $239.88 | $426.58 |
CDPHP Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $371.54 | Facility | None | $338.84 | $338.84 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Emblem Health Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,949.84 | Facility | None | $537.03 | $870.96 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $954.99 | Professional | None | $346.74 | $562.34 | $954.99 |
Excellus BCBS Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $436.52 | Professional | None | $316.23 | $371.54 | $436.52 |
MVP Health Care Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $776.25 | Professional | None | $309.03 | $309.03 | $776.25 |
United Setting Facility Modifier None Typical Low $263.03 Median $363.08 Typical High $851.14 | Facility | None | $263.03 | $363.08 | $851.14 |
United Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $398.11 | Professional | None | $173.78 | $323.59 | $398.11 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $371.54 Typical High $371.54 | Facility | None | $316.23 | $371.54 | $371.54 |
Univera Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $436.52 | Professional | None | $316.23 | $371.54 | $436.52 |
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 $114.82 Median $114.82 Typical High $165.96 | Professional | 52 · Reduced service | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | 53 · Discontinued | $45.71 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $33.11 |
Highmark BCBS Setting Professional Modifier K3 · Prosthesis level 3 Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | K3 · Prosthesis level 3 | $426.58 | $426.58 | $426.58 |
Where New York sits
The same service costs 2.8 times more in Wyoming 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· 30th of 51
$324
WY $676DE $245
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.