How much rates vary
Facilitymedian $174 · 10th to 90th $112 to $490Professionalmedian $170 · 10th to 90th $123 to $389
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 $102.33 Median $123.03 Typical High $177.83 | Facility | None | $102.33 | $123.03 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $177.83 | Professional | None | $123.03 | $123.03 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $575.44 | Facility | None | $288.40 | $288.40 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $478.63 | Professional | None | $169.82 | $177.83 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $37.15 | Professional | RR · Rental | $16.98 | $16.98 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $128.82 Median $128.82 Typical High $229.09 | Professional | UE · Used equipment | $128.82 | $128.82 | $229.09 |
CDPHP Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $194.98 | Facility | None | $173.78 | $173.78 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $288.40 Median $467.74 Typical High $1,023.29 | Facility | None | $288.40 | $467.74 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $501.19 | Professional | None | $186.21 | $302.00 | $501.19 |
Excellus BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $234.42 | Professional | None | $112.20 | $169.82 | $234.42 |
MVP Health Care Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
MVP Health Care Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $416.87 | Professional | None | $165.96 | $165.96 | $416.87 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $457.09 | Facility | None | $186.21 | $229.09 | $457.09 |
United Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $213.80 | Professional | None | $93.33 | $169.82 | $213.80 |
Univera Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $169.82 | Facility | None | $112.20 | $112.20 | $169.82 |
Univera Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $234.42 | Professional | None | $112.20 | $169.82 | $234.42 |
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 $60.26 Median $60.26 Typical High $89.13 | Professional | 52 · Reduced service | $60.26 | $60.26 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $35.48 | Professional | 53 · Discontinued | $24.55 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $26.30 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $17.78 |
Where New York sits
The same service costs 4.0 times more in Hawaii 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· 43rd of 51
$170
HI $525FL $132
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.