How much rates vary
Facilitymedian $288 · 10th to 90th $229 to $794Professionalmedian $269 · 10th to 90th $204 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 $173.78 Median $204.17 Typical High $295.12 | Facility | None | $173.78 | $204.17 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $295.12 | Professional | None | $204.17 | $204.17 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $489.78 Typical High $954.99 | Facility | None | $478.63 | $489.78 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $812.83 | Professional | None | $218.78 | $229.09 | $812.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $47.86 | Professional | RR · Rental | $21.88 | $21.88 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $295.12 | Professional | UE · Used equipment | $165.96 | $165.96 | $295.12 |
CDPHP Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $251.19 | Facility | None | $229.09 | $229.09 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Emblem Health Setting Facility Modifier None Typical Low $478.63 Median $794.33 Typical High $1,737.80 | Facility | None | $478.63 | $794.33 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $851.14 | Professional | None | $309.03 | $478.63 | $851.14 |
Excellus BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $389.05 | Professional | None | $281.84 | $288.40 | $389.05 |
MVP Health Care Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
MVP Health Care Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $691.83 | Professional | None | $281.84 | $281.84 | $691.83 |
United Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $602.56 | Facility | None | $151.36 | $190.55 | $602.56 |
United Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $316.23 | Professional | None | $154.88 | $275.42 | $316.23 |
Univera Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $295.12 | Facility | None | $281.84 | $288.40 | $295.12 |
Univera Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $389.05 | Professional | None | $281.84 | $288.40 | $389.05 |
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 $102.33 Median $102.33 Typical High $147.91 | Professional | 52 · Reduced service | $102.33 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $40.74 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $29.51 |
Where New York sits
The same service costs 2.7 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· 20th of 51
$275
MT $457DE $170
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.