How much rates vary
Facilitymedian $141 · 10th to 90th $85 to $380Professionalmedian $135 · 10th to 90th $95 to $324
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 $79.43 Median $95.50 Typical High $138.04 | Facility | None | $79.43 | $95.50 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | None | $95.50 | $95.50 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $446.68 | Facility | None | $223.87 | $229.09 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $398.11 | Professional | None | $134.90 | $134.90 | $398.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.18 Median $13.18 Typical High $28.84 | Professional | RR · Rental | $13.18 | $13.18 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $177.83 | Professional | UE · Used equipment | $100.00 | $100.00 | $177.83 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $154.88 | Facility | None | $141.25 | $141.25 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $794.33 | Facility | None | $223.87 | $363.08 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $389.05 | Professional | None | $144.54 | $234.42 | $389.05 |
Excellus BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $181.97 | Professional | None | $85.11 | $131.83 | $181.97 |
MVP Health Care Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
MVP Health Care Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $323.59 | Professional | None | $128.82 | $128.82 | $323.59 |
United Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $354.81 | Facility | None | $144.54 | $158.49 | $354.81 |
United Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $165.96 | Professional | None | $72.44 | $131.83 | $165.96 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $131.83 | Facility | None | $85.11 | $85.11 | $131.83 |
Univera Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $181.97 | Professional | None | $85.11 | $131.83 | $181.97 |
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 $47.86 Median $47.86 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $27.54 | Professional | 53 · Discontinued | $19.05 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $20.42 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $13.80 |
Where New York sits
The same service costs 3.7 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· 36th of 51
$135
HI $380FL $102
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.