How much rates vary
Facilitymedian $3,311 · 10th to 90th $2,754 to $9,120Professionalmedian $3,162 · 10th to 90th $2,630 to $7,762
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 $1,905.46 Median $2,290.87 Typical High $3,311.31 | Facility | None | $1,905.46 | $2,290.87 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,290.87 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $10,715.19 | Facility | None | $5,370.32 | $5,495.41 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $9,332.54 | Professional | None | $3,162.28 | $3,162.28 | $9,332.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $316.23 Median $316.23 Typical High $691.83 | Professional | RR · Rental | $316.23 | $316.23 | $691.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,398.83 Median $2,398.83 Typical High $4,265.80 | Professional | UE · Used equipment | $2,398.83 | $2,398.83 | $4,265.80 |
CDPHP Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,168.69 | Facility | None | $3,715.35 | $3,715.35 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $5,370.32 Median $8,912.51 Typical High $19,498.45 | Facility | None | $5,370.32 | $8,912.51 | $19,498.45 |
Emblem Health Setting Professional Modifier None Typical Low $3,467.37 Median $5,623.41 Typical High $9,549.93 | Professional | None | $3,467.37 | $5,623.41 | $9,549.93 |
Excellus BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,754.23 | $3,162.28 | $4,365.16 |
MVP Health Care Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
MVP Health Care Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $7,762.47 | Professional | None | $3,090.30 | $3,090.30 | $7,762.47 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $7,079.46 Typical High $9,120.11 | Facility | None | $3,467.37 | $7,079.46 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $3,235.94 Typical High $3,981.07 | Professional | None | $1,737.80 | $3,235.94 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,235.94 | Facility | None | $2,754.23 | $2,754.23 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,754.23 | $3,162.28 | $4,365.16 |
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 $1,148.15 Median $1,148.15 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $660.69 | Professional | 53 · Discontinued | $457.09 | $457.09 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $489.78 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $331.13 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $331.13 |
Where New York sits
The same service costs 2.9 times more in Hawaii than in Pennsylvania. 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· 37th of 51
$3,162
HI $7,943PA $2,754
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.