How much rates vary
Facilitymedian $1,738 · 10th to 90th $1,380 to $3,802Professionalmedian $1,349 · 10th to 90th $1,023 to $3,020
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 $831.76 Median $1,000.00 Typical High $1,445.44 | Facility | None | $831.76 | $1,000.00 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,000.00 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $4,677.35 | Facility | None | $2,344.23 | $2,344.23 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $3,981.07 | Professional | None | $1,122.02 | $1,148.15 | $3,981.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $245.47 | Professional | RR · Rental | $112.20 | $112.20 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $1,513.56 | Professional | UE · Used equipment | $851.14 | $851.14 | $1,513.56 |
CDPHP Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,513.56 | Facility | None | $1,412.54 | $1,412.54 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Emblem Health Setting Facility Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $8,317.64 | Facility | None | $2,344.23 | $3,801.89 | $8,317.64 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $4,073.80 | Professional | None | $1,513.56 | $2,344.23 | $4,073.80 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,737.80 | $1,905.46 |
MVP Health Care Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,348.96 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $3,019.95 | Facility | None | $1,230.27 | $1,318.26 | $3,019.95 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,348.96 Typical High $1,548.82 | Professional | None | $758.58 | $1,348.96 | $1,548.82 |
Univera Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,380.38 | $1,737.80 | $1,737.80 |
Univera Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,737.80 | $1,905.46 |
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 $501.19 Median $501.19 Typical High $724.44 | Professional | 52 · Reduced service | $501.19 | $501.19 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $288.40 | Professional | 53 · Discontinued | $199.53 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $144.54 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $144.54 |
Where New York sits
The same service costs 3.6 times more in Hawaii than in Washington, DC. 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· 22nd of 51
$1,349
HI $3,548DC $977
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.