How much rates vary
Facilitymedian $3,236 · 10th to 90th $2,570 to $7,244Professionalmedian $2,570 · 10th to 90th $1,862 to $5,888
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 $1,548.82 Median $1,862.09 Typical High $2,691.53 | Facility | None | $1,548.82 | $1,862.09 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,862.09 | $1,862.09 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $4,466.84 Typical High $8,709.64 | Facility | None | $4,365.16 | $4,466.84 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $7,413.10 | Professional | None | $2,511.89 | $2,570.40 | $7,413.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $251.19 Median $251.19 Typical High $549.54 | Professional | RR · Rental | $251.19 | $251.19 | $549.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $1,905.46 Typical High $3,388.44 | Professional | UE · Used equipment | $1,905.46 | $1,905.46 | $3,388.44 |
CDPHP Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,715.35 | Facility | None | $3,388.44 | $3,388.44 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $4,365.16 Median $7,244.36 Typical High $15,848.93 | Facility | None | $4,365.16 | $7,244.36 | $15,848.93 |
Emblem Health Setting Professional Modifier None Typical Low $2,818.38 Median $4,570.88 Typical High $7,762.47 | Professional | None | $2,818.38 | $4,570.88 | $7,762.47 |
Excellus BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $3,548.13 | Professional | None | $2,570.40 | $3,235.94 | $3,548.13 |
MVP Health Care Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
MVP Health Care Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $6,309.57 | Professional | None | $1,621.81 | $1,621.81 | $6,309.57 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,495.41 Typical High $7,244.36 | Facility | None | $2,398.83 | $5,495.41 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $3,162.28 | Professional | None | $1,412.54 | $2,630.27 | $3,162.28 |
Univera Setting Facility Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $3,235.94 | Facility | None | $2,570.40 | $3,235.94 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $3,548.13 | Professional | None | $2,570.40 | $3,235.94 | $3,548.13 |
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 $933.25 Median $933.25 Typical High $1,348.96 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | 53 · Discontinued | $371.54 | $371.54 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $398.11 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $269.15 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $269.15 |
Where New York sits
The same service costs 2.1 times more in Montana than in South Carolina. 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· 28th of 51
$2,570
MT $4,898SC $2,344
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.