How much rates vary
Facilitymedian $251 · 10th to 90th $100 to $724Professionalmedian $269 · 10th to 90th $174 to $617
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 $147.91 Median $173.78 Typical High $257.04 | Facility | None | $147.91 | $173.78 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $257.04 | Professional | None | $173.78 | $173.78 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $416.87 Typical High $831.76 | Facility | None | $407.38 | $416.87 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $776.25 | Professional | None | $331.13 | $331.13 | $776.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $70.79 | Professional | RR · Rental | $32.36 | $32.36 | $70.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $436.52 | Professional | UE · Used equipment | $239.88 | $239.88 | $436.52 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $288.40 | Facility | None | $263.03 | $263.03 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Emblem Health Setting Facility Modifier None Typical Low $407.38 Median $676.08 Typical High $1,479.11 | Facility | None | $407.38 | $676.08 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $724.44 | Professional | None | $269.15 | $407.38 | $724.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $100.00 Median $239.88 Typical High $338.84 | Professional | None | $100.00 | $239.88 | $338.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
MVP Health Care Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $602.56 | Professional | None | $239.88 | $239.88 | $602.56 |
United Setting Facility Modifier None Typical Low $263.03 Median $549.54 Typical High $707.95 | Facility | None | $263.03 | $549.54 | $707.95 |
United Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $309.03 | Professional | None | $134.90 | $245.47 | $309.03 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $239.88 | Facility | None | $100.00 | $100.00 | $239.88 |
Univera Setting Professional Modifier None Typical Low $100.00 Median $239.88 Typical High $338.84 | Professional | None | $100.00 | $239.88 | $338.84 |
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 $87.10 Median $87.10 Typical High $125.89 | Professional | 52 · Reduced service | $87.10 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | 53 · Discontinued | $35.48 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $38.02 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $25.70 |
Where New York sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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· 35th of 51
$269
HI $562DE $191
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.