How much rates vary
Facilitymedian $589 · 10th to 90th $331 to $1,514Professionalmedian $537 · 10th to 90th $380 to $1,202
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 $323.59 Median $380.19 Typical High $549.54 | Facility | None | $323.59 | $380.19 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $549.54 | Professional | None | $380.19 | $380.19 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $1,778.28 | Facility | None | $891.25 | $912.01 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $1,513.56 | Professional | None | $537.03 | $549.54 | $1,513.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $114.82 | Professional | RR · Rental | $53.70 | $53.70 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $398.11 Median $398.11 Typical High $707.95 | Professional | UE · Used equipment | $398.11 | $398.11 | $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 $616.60 Median $616.60 Typical High $676.08 | Facility | None | $616.60 | $616.60 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Emblem Health Setting Facility Modifier None Typical Low $891.25 Median $1,479.11 Typical High $3,235.94 | Facility | None | $891.25 | $1,479.11 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $1,584.89 | Professional | None | $575.44 | $954.99 | $1,584.89 |
Excellus BCBS Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $724.44 | Professional | None | $331.13 | $524.81 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,318.26 | Professional | None | $524.81 | $524.81 | $1,318.26 |
United Setting Facility Modifier None Typical Low $588.84 Median $707.95 Typical High $1,412.54 | Facility | None | $588.84 | $707.95 | $1,412.54 |
United Setting Professional Modifier None Typical Low $288.40 Median $537.03 Typical High $676.08 | Professional | None | $288.40 | $537.03 | $676.08 |
Univera Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $524.81 | Facility | None | $331.13 | $331.13 | $524.81 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $724.44 | Professional | None | $331.13 | $524.81 | $724.44 |
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 $190.55 Median $190.55 Typical High $275.42 | Professional | 52 · Reduced service | $190.55 | $190.55 | $275.42 |
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 $57.54 Median $57.54 Typical High $83.18 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $54.95 |
Highmark BCBS Setting Professional Modifier K3 · Prosthesis level 3 Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | K3 · Prosthesis level 3 | $707.95 | $707.95 | $707.95 |
Where New York sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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· 40th of 51
$537
HI $1,660TN $447
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.