How much rates vary
Facilitymedian $479 · 10th to 90th $398 to $1,148Professionalmedian $407 · 10th to 90th $295 to $933
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 $251.19 Median $295.12 Typical High $426.58 | Facility | None | $251.19 | $295.12 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $426.58 | Professional | None | $295.12 | $295.12 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $1,380.38 | Facility | None | $691.83 | $707.95 | $1,380.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $1,174.90 | Professional | None | $380.19 | $398.11 | $1,174.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $83.18 | Professional | RR · Rental | $38.02 | $38.02 | $83.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $288.40 Typical High $512.86 | Professional | UE · Used equipment | $288.40 | $288.40 | $512.86 |
CDPHP Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $436.52 | Facility | None | $398.11 | $398.11 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $2,511.89 | Facility | None | $691.83 | $1,148.15 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,230.27 | Professional | None | $457.09 | $724.44 | $1,230.27 |
Excellus BCBS Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $562.34 | Professional | None | $407.38 | $478.63 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
MVP Health Care Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $1,023.29 | Professional | None | $407.38 | $407.38 | $1,023.29 |
United Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $1,122.02 | Facility | None | $363.08 | $851.14 | $1,122.02 |
United Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $489.78 | Professional | None | $229.09 | $416.87 | $489.78 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $478.63 Typical High $478.63 | Facility | None | $407.38 | $478.63 | $478.63 |
Univera Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $562.34 | Professional | None | $407.38 | $478.63 | $562.34 |
5 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 $147.91 Median $147.91 Typical High $213.80 | Professional | 52 · Reduced service | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | 53 · Discontinued | $58.88 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $64.57 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $42.66 |
Highmark BCBS Setting Professional Modifier K3 · Prosthesis level 3 Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | K3 · Prosthesis level 3 | $549.54 | $549.54 | $549.54 |
Where New York sits
The same service costs 2.8 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· 25th of 51
$407
HI $794DE $288
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.