How much rates vary
Facilitymedian $4,786 · 10th to 90th $2,818 to $9,550Professionalmedian $3,020 · 10th to 90th $2,089 to $6,457
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 $1,737.80 Median $2,041.74 Typical High $2,951.21 | Facility | None | $1,737.80 | $2,041.74 | $2,951.21 |
Aetna Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,041.74 Typical High $2,951.21 | Professional | None (both parts) | $2,041.74 | $2,041.74 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $4,897.79 Typical High $9,549.93 | Facility | None | $4,786.30 | $4,897.79 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $2,884.03 Median $3,019.95 Typical High $8,128.31 | Professional | None (both parts) | $2,884.03 | $3,019.95 | $8,128.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $288.40 Median $288.40 Typical High $630.96 | Professional | RR · Rental | $288.40 | $288.40 | $630.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,187.76 Median $2,187.76 Typical High $3,890.45 | Professional | UE · Used equipment | $2,187.76 | $2,187.76 | $3,890.45 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None (both parts) | $3,890.45 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,235.94 | Facility | None | $2,884.03 | $2,884.03 | $3,235.94 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None (both parts) | $2,089.30 | $2,089.30 | $2,089.30 |
Emblem Health Setting Facility Modifier None Typical Low $4,786.30 Median $7,943.28 Typical High $17,378.01 | Facility | None | $4,786.30 | $7,943.28 | $17,378.01 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $3,090.30 Median $4,786.30 Typical High $8,511.38 | Professional | None (both parts) | $3,090.30 | $4,786.30 | $8,511.38 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $2,818.38 Median $3,715.35 Typical High $3,890.45 | Professional | None (both parts) | $2,818.38 | $3,715.35 | $3,890.45 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $2,884.03 Median $2,884.03 Typical High $7,079.46 | Professional | None (both parts) | $2,884.03 | $2,884.03 | $7,079.46 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $7,585.78 | Facility | None | $5,888.44 | $5,888.44 | $7,585.78 |
United Setting Professional Modifier None (both parts) Typical Low $1,584.89 Median $2,884.03 Typical High $3,311.31 | Professional | None (both parts) | $1,584.89 | $2,884.03 | $3,311.31 |
Univera Setting Facility Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $3,162.28 | Facility | None | $2,691.53 | $2,818.38 | $3,162.28 |
Univera Setting Professional Modifier None (both parts) Typical Low $2,818.38 Median $3,715.35 Typical High $3,890.45 | Professional | None (both parts) | $2,818.38 | $3,715.35 | $3,890.45 |
3 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 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $446.68 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $295.12 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $295.12 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $12.30 Median $19.05 Typical High $25.12 | Professional | 26 · Professional part | $12.30 | $19.05 | $25.12 |
Where New York sits
The same service costs 2.4 times more in Montana 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· 24th of 51
$3,020
MT $5,012DE $2,089
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.