How much rates vary
Facilitymedian $525 · 10th to 90th $380 to $1,514Professionalmedian $525 · 10th to 90th $380 to $1,175
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 $316.23 Median $371.54 Typical High $549.54 | Facility | None | $316.23 | $371.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $549.54 | Professional | None | $371.54 | $371.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $891.25 Typical High $1,778.28 | Facility | None | $870.96 | $891.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,479.11 | Professional | None | $524.81 | $537.03 | $1,479.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $112.20 | Professional | RR · Rental | $52.48 | $52.48 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $389.05 Typical High $707.95 | Professional | UE · Used equipment | $389.05 | $389.05 | $707.95 |
CDPHP Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $645.65 | Facility | None | $588.84 | $588.84 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Emblem Health Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $3,162.28 | Facility | None | $870.96 | $1,445.44 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,548.82 | Professional | None | $575.44 | $933.25 | $1,548.82 |
Excellus BCBS Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $724.44 | Professional | None | $380.19 | $524.81 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
MVP Health Care Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,288.25 | Professional | None | $512.86 | $512.86 | $1,288.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $1,412.54 | Facility | None | $501.19 | $524.81 | $1,412.54 |
United Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $660.69 | Professional | None | $288.40 | $524.81 | $660.69 |
Univera Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Facility | None | $380.19 | $380.19 | $524.81 |
Univera Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $724.44 | Professional | None | $380.19 | $524.81 | $724.44 |
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 $186.21 Median $186.21 Typical High $269.15 | Professional | 52 · Reduced service | $186.21 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $109.65 | Professional | 53 · Discontinued | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $81.28 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $54.95 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $54.95 |
Where New York sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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· 39th of 51
$525
HI $1,175WV $427
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.