How much rates vary
Facilitymedian $275 · 10th to 90th $269 to $759Professionalmedian $269 · 10th to 90th $200 to $603
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 $158.49 Median $190.55 Typical High $275.42 | Facility | None | $158.49 | $190.55 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $275.42 | Professional | None | $190.55 | $190.55 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $457.09 Typical High $891.25 | Facility | None | $446.68 | $457.09 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $758.58 | Professional | None | $263.03 | $269.15 | $758.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.30 Median $26.30 Typical High $57.54 | Professional | RR · Rental | $26.30 | $26.30 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $354.81 | Professional | UE · Used equipment | $199.53 | $199.53 | $354.81 |
CDPHP Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $302.00 | Facility | None | $269.15 | $269.15 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Emblem Health Setting Facility Modifier None Typical Low $446.68 Median $724.44 Typical High $1,584.89 | Facility | None | $446.68 | $724.44 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $776.25 | Professional | None | $288.40 | $467.74 | $776.25 |
Excellus BCBS Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $363.08 | Professional | None | $263.03 | $275.42 | $363.08 |
MVP Health Care Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
MVP Health Care Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $645.65 | Professional | None | $257.04 | $257.04 | $645.65 |
United Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $707.95 | Facility | None | $281.84 | $288.40 | $707.95 |
United Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $331.13 | Professional | None | $144.54 | $269.15 | $331.13 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $275.42 Typical High $275.42 | Facility | None | $263.03 | $275.42 | $275.42 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $363.08 | Professional | None | $263.03 | $275.42 | $363.08 |
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 $95.50 Median $95.50 Typical High $138.04 | Professional | 52 · Reduced service | $95.50 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $40.74 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $27.54 |
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· 33rd of 51
$269
HI $661DE $200
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.