How much rates vary
Facilitymedian $100 · 10th to 90th $91 to $263Professionalmedian $95 · 10th to 90th $72 to $224
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 $54.95 Median $95.50 Typical High $177.83 | Facility | None | $54.95 | $95.50 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $95.50 | Professional | None | $66.07 | $66.07 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $309.03 | Facility | None | $154.88 | $158.49 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $275.42 | Professional | None | $95.50 | $95.50 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $20.42 | Professional | RR · Rental | $9.33 | $9.33 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $125.89 | Professional | UE · Used equipment | $69.18 | $69.18 | $125.89 |
CDPHP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $109.65 | Facility | None | $100.00 | $100.00 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Emblem Health Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $562.34 | Facility | None | $154.88 | $251.19 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $275.42 | Professional | None | $100.00 | $154.88 | $275.42 |
Excellus BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $125.89 | Professional | None | $91.20 | $95.50 | $125.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
MVP Health Care Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
MVP Health Care Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $223.87 | Professional | None | $93.33 | $93.33 | $223.87 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $245.47 | Facility | None | $186.21 | $186.21 | $245.47 |
United Setting Professional Modifier None Typical Low $50.12 Median $93.33 Typical High $107.15 | Professional | None | $50.12 | $93.33 | $107.15 |
Univera Setting Facility Modifier None Typical Low $87.10 Median $95.50 Typical High $95.50 | Facility | None | $87.10 | $95.50 | $95.50 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $125.89 | Professional | None | $91.20 | $95.50 | $125.89 |
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 $9.77 Median $9.77 Typical High $14.13 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $9.55 |
Where New York sits
The same service costs 2.2 times more in Montana than in Florida. 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
$95.50
MT $158FL $72.44
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.