How much rates vary
Facilitymedian $204 · 10th to 90th $182 to $575Professionalmedian $204 · 10th to 90th $148 to $490
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 $123.03 Median $147.91 Typical High $213.80 | Facility | None | $123.03 | $147.91 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | None | $147.91 | $147.91 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $691.83 | Facility | None | $346.74 | $346.74 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $602.56 | Professional | None | $204.17 | $204.17 | $602.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $42.66 | Professional | RR · Rental | $19.50 | $19.50 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $147.91 Typical High $263.03 | Professional | UE · Used equipment | $147.91 | $147.91 | $263.03 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $223.87 | Facility | None | $204.17 | $204.17 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Emblem Health Setting Facility Modifier None Typical Low $346.74 Median $562.34 Typical High $1,230.27 | Facility | None | $346.74 | $562.34 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $602.56 | Professional | None | $223.87 | $354.81 | $602.56 |
Excellus BCBS Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $281.84 | Professional | None | $181.97 | $204.17 | $281.84 |
MVP Health Care Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
MVP Health Care Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $501.19 | Professional | None | $199.53 | $199.53 | $501.19 |
United Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $537.03 | Facility | None | $181.97 | $218.78 | $537.03 |
United Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $251.19 | Professional | None | $112.20 | $204.17 | $251.19 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $208.93 | Facility | None | $181.97 | $181.97 | $208.93 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $281.84 | Professional | None | $181.97 | $204.17 | $281.84 |
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 $74.13 Median $74.13 Typical High $107.15 | Professional | 52 · Reduced service | $74.13 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | 53 · Discontinued | $29.51 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $31.62 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $21.38 |
Where New York sits
The same service costs 3.3 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· 31st of 51
$204
HI $501DE $151
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.