How much rates vary
Facilitymedian $55 · 10th to 90th $45 to $138Professionalmedian $47 · 10th to 90th $35 to $107
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 $30.20 Median $35.48 Typical High $51.29 | Facility | None | $30.20 | $35.48 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | None | $35.48 | $35.48 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $85.11 Typical High $165.96 | Facility | None | $83.18 | $85.11 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $141.25 | Professional | None | $38.90 | $40.74 | $141.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $3.89 Typical High $8.51 | Professional | RR · Rental | $3.89 | $3.89 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $52.48 | Professional | UE · Used equipment | $29.51 | $29.51 | $52.48 |
CDPHP Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $50.12 | Facility | None | $44.67 | $44.67 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Emblem Health Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $302.00 | Facility | None | $83.18 | $138.04 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $147.91 | Professional | None | $53.70 | $83.18 | $147.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $67.61 | Professional | None | $48.98 | $54.95 | $67.61 |
MVP Health Care Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
MVP Health Care Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $123.03 | Professional | None | $48.98 | $48.98 | $123.03 |
United Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $100.00 | Facility | None | $36.31 | $37.15 | $100.00 |
United Setting Professional Modifier None Typical Low $26.92 Median $45.71 Typical High $56.23 | Professional | None | $26.92 | $45.71 | $56.23 |
Univera Setting Facility Modifier None Typical Low $48.98 Median $54.95 Typical High $54.95 | Facility | None | $48.98 | $54.95 | $54.95 |
Univera Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $67.61 | Professional | None | $48.98 | $54.95 | $67.61 |
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 $17.78 Median $17.78 Typical High $25.70 | Professional | 52 · Reduced service | $17.78 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $10.23 | Professional | 53 · Discontinued | $7.08 | $7.08 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $7.76 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $5.13 |
Where New York sits
The same service costs 2.5 times more in Hawaii 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· 18th of 51
$46.77
HI $81.28FL $33.11
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.