How much rates vary
Facilitymedian $955 · 10th to 90th $933 to $2,570Professionalmedian $871 · 10th to 90th $676 to $1,995
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 $562.34 Median $676.08 Typical High $977.24 | Facility | None | $562.34 | $676.08 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $977.24 | Professional | None | $676.08 | $676.08 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $3,162.28 | Facility | None | $1,548.82 | $1,584.89 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $2,630.27 | Professional | None | $691.83 | $724.44 | $2,630.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $151.36 | Professional | RR · Rental | $69.18 | $69.18 | $151.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $524.81 Median $524.81 Typical High $933.25 | Professional | UE · Used equipment | $524.81 | $524.81 | $933.25 |
CDPHP Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Facility | None | $933.25 | $933.25 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Emblem Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,570.40 Typical High $5,623.41 | Facility | None | $1,548.82 | $2,570.40 | $5,623.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,023.29 | $1,548.82 | $2,754.23 |
Excellus BCBS Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,288.25 | Professional | None | $933.25 | $954.99 | $1,288.25 |
MVP Health Care Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
MVP Health Care Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $2,290.87 | Professional | None | $912.01 | $912.01 | $2,290.87 |
United Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $1,905.46 | Facility | None | $478.63 | $575.44 | $1,905.46 |
United Setting Professional Modifier None Typical Low $512.86 Median $870.96 Typical High $1,023.29 | Professional | None | $512.86 | $870.96 | $1,023.29 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $954.99 Typical High $954.99 | Facility | None | $933.25 | $954.99 | $954.99 |
Univera Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,288.25 | Professional | None | $933.25 | $954.99 | $1,288.25 |
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 $331.13 Median $331.13 Typical High $489.78 | Professional | 52 · Reduced service | $331.13 | $331.13 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | 53 · Discontinued | $134.90 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $144.54 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $97.72 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $97.72 |
Highmark BCBS Setting Professional Modifier K3 · Prosthesis level 3 Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | K3 · Prosthesis level 3 | $1,258.93 | $1,258.93 | $1,258.93 |
Where New York sits
The same service costs 2.1 times more in Wisconsin 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· 18th of 51
$891
WI $1,349DC $646
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.