How much rates vary
Facilitymedian $282 · 10th to 90th $240 to $759Professionalmedian $269 · 10th to 90th $204 to $676
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 $165.96 Median $199.53 Typical High $288.40 | Facility | None | $165.96 | $199.53 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $288.40 | Professional | None | $199.53 | $199.53 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $933.25 | Facility | None | $467.74 | $467.74 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $812.83 | Professional | None | $269.15 | $269.15 | $812.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $58.88 | Professional | RR · Rental | $26.92 | $26.92 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $363.08 | Professional | UE · Used equipment | $199.53 | $199.53 | $363.08 |
CDPHP Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $302.00 | Facility | None | $281.84 | $281.84 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Emblem Health Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $1,659.59 | Facility | None | $467.74 | $758.58 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $812.83 | Professional | None | $302.00 | $489.78 | $812.83 |
Excellus BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $380.19 | Professional | None | $239.88 | $275.42 | $380.19 |
MVP Health Care Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $676.08 | Professional | None | $269.15 | $269.15 | $676.08 |
United Setting Facility Modifier None Typical Low $288.40 Median $389.05 Typical High $707.95 | Facility | None | $288.40 | $389.05 | $707.95 |
United Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $331.13 | Professional | None | $151.36 | $275.42 | $331.13 |
Univera Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $288.40 | Facility | None | $239.88 | $239.88 | $288.40 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $380.19 | Professional | None | $239.88 | $275.42 | $380.19 |
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 $97.72 Median $97.72 Typical High $144.54 | Professional | 52 · Reduced service | $97.72 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $57.54 | Professional | 53 · Discontinued | $39.81 | $39.81 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $28.84 |
Where New York sits
The same service costs 4.1 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· 34th of 51
$269
HI $832DE $204
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.