How much rates vary
Facilitymedian $457 · 10th to 90th $355 to $1,072Professionalmedian $427 · 10th to 90th $275 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 $380.19 Typical High $691.83 | Facility | None | $218.78 | $380.19 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $380.19 | Professional | None | $257.04 | $257.04 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $1,230.27 | Facility | None | $602.56 | $616.60 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,122.02 | Professional | None | $426.58 | $426.58 | $1,122.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $89.13 | Professional | RR · Rental | $41.69 | $41.69 | $89.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $549.54 | Professional | UE · Used equipment | $309.03 | $309.03 | $549.54 |
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 $380.19 Median $380.19 Typical High $426.58 | Facility | None | $380.19 | $380.19 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Emblem Health Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $2,187.76 | Facility | None | $602.56 | $1,000.00 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,071.52 | Professional | None | $398.11 | $602.56 | $1,071.52 |
Excellus BCBS Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $501.19 | Professional | None | $354.81 | $457.09 | $501.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $1,148.15 | Facility | None | $602.56 | $602.56 | $1,148.15 |
Highmark BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
MVP Health Care Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $891.25 | Professional | None | $371.54 | $371.54 | $891.25 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Facility | None | $812.83 | $812.83 | $1,047.13 |
United Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $457.09 | Professional | None | $199.53 | $363.08 | $457.09 |
Univera Setting Facility Modifier None Typical Low $354.81 Median $457.09 Typical High $457.09 | Facility | None | $354.81 | $457.09 | $457.09 |
Univera Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $501.19 | Professional | None | $354.81 | $457.09 | $501.19 |
2 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 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 $25.70 Median $25.70 Typical High $38.02 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $38.02 |
Where New York sits
The same service costs 3.7 times more in Alaska 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· 26th of 51
$427
AK $1,023DE $275
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.