How much rates vary
Facilitymedian $60 · 10th to 90th $55 to $166Professionalmedian $58 · 10th to 90th $44 to $145
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 $35.48 Median $41.69 Typical High $60.26 | Facility | None | $35.48 | $41.69 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | None | $41.69 | $41.69 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $194.98 | Facility | None | $97.72 | $100.00 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $169.82 | Professional | None | $57.54 | $57.54 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $12.59 | Professional | RR · Rental | $5.75 | $5.75 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $43.65 Typical High $87.10 | Professional | UE · Used equipment | $43.65 | $43.65 | $87.10 |
CDPHP Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Facility | None | $60.26 | $60.26 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Emblem Health Setting Facility Modifier None Typical Low $97.72 Median $162.18 Typical High $354.81 | Facility | None | $97.72 | $162.18 | $354.81 |
Emblem Health Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $173.78 | Professional | None | $64.57 | $104.71 | $173.78 |
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 $54.95 Median $57.54 Typical High $79.43 | Professional | None | $54.95 | $57.54 | $79.43 |
MVP Health Care Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
MVP Health Care Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $144.54 | Professional | None | $57.54 | $57.54 | $144.54 |
United Setting Facility Modifier None Typical Low $64.57 Median $67.61 Typical High $158.49 | Facility | None | $64.57 | $67.61 | $158.49 |
United Setting Professional Modifier None Typical Low $32.36 Median $58.88 Typical High $74.13 | Professional | None | $32.36 | $58.88 | $74.13 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Facility | None | $54.95 | $54.95 | $60.26 |
Univera Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $79.43 | Professional | None | $54.95 | $57.54 | $79.43 |
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 $20.89 Median $20.89 Typical High $30.20 | Professional | 52 · Reduced service | $20.89 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $12.02 | Professional | 53 · Discontinued | $8.32 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $9.12 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $6.03 |
Where New York sits
The same service costs 3.6 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· 40th of 51
$57.54
HI $158DE $43.65
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.