How much rates vary
Facilitymedian $98 · 10th to 90th $60 to $269Professionalmedian $95 · 10th to 90th $71 to $224
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 $58.88 Median $70.79 Typical High $102.33 | Facility | None | $58.88 | $70.79 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | None | $70.79 | $70.79 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $331.13 | Facility | None | $165.96 | $165.96 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $275.42 | Professional | None | $93.33 | $95.50 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $20.42 | Professional | RR · Rental | $9.33 | $9.33 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $125.89 | Professional | UE · Used equipment | $69.18 | $69.18 | $125.89 |
CDPHP Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $109.65 | Facility | None | $100.00 | $100.00 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Emblem Health Setting Facility Modifier None Typical Low $165.96 Median $269.15 Typical High $588.84 | Facility | None | $165.96 | $269.15 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $288.40 | Professional | None | $107.15 | $154.88 | $288.40 |
Excellus BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $134.90 | Professional | None | $60.26 | $97.72 | $134.90 |
Highmark BCBS Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $239.88 | Professional | None | $95.50 | $95.50 | $239.88 |
United Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $251.19 | Facility | None | $60.26 | $75.86 | $251.19 |
United Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $117.49 | Professional | None | $53.70 | $97.72 | $117.49 |
Univera Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $97.72 | Facility | None | $60.26 | $60.26 | $97.72 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $134.90 | Professional | None | $60.26 | $97.72 | $134.90 |
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 $34.67 Median $34.67 Typical High $51.29 | Professional | 52 · Reduced service | $34.67 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $20.42 | Professional | 53 · Discontinued | $14.13 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $15.14 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $10.23 |
Where New York sits
The same service costs 2.9 times more in Montana than in Florida. 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· 32nd of 51
$95.50
MT $209FL $72.44
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.