How much rates vary
Facilitymedian $646 · 10th to 90th $537 to $1,862Professionalmedian $661 · 10th to 90th $537 to $1,622
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 $398.11 Median $467.74 Typical High $676.08 | Facility | None | $398.11 | $467.74 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $676.08 | Professional | None | $467.74 | $467.74 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,122.02 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,949.84 | Professional | None | $660.69 | $660.69 | $1,949.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $144.54 | Professional | RR · Rental | $66.07 | $66.07 | $144.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $489.78 Median $489.78 Typical High $891.25 | Professional | UE · Used equipment | $489.78 | $489.78 | $891.25 |
CDPHP Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $3,981.07 | Facility | None | $1,096.48 | $1,819.70 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $1,174.90 Typical High $1,949.84 | Professional | None | $724.44 | $1,174.90 | $1,949.84 |
Excellus BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $912.01 | Professional | None | $537.03 | $645.65 | $912.01 |
MVP Health Care Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,621.81 | Professional | None | $645.65 | $645.65 | $1,621.81 |
United Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $1,778.28 | Facility | None | $616.60 | $645.65 | $1,778.28 |
United Setting Professional Modifier None Typical Low $363.08 Median $660.69 Typical High $831.76 | Professional | None | $363.08 | $660.69 | $831.76 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $645.65 | Facility | None | $537.03 | $537.03 | $645.65 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $912.01 | Professional | None | $537.03 | $645.65 | $912.01 |
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 $234.42 Median $234.42 Typical High $338.84 | Professional | 52 · Reduced service | $234.42 | $234.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $138.04 | Professional | 53 · Discontinued | $93.33 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $67.61 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $67.61 |
Where New York sits
The same service costs 2.3 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· 34th of 51
$661
HI $1,413PA $617
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.