How much rates vary
Facilitymedian $234 · 10th to 90th $151 to $603Professionalmedian $219 · 10th to 90th $151 to $525
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 $128.82 Median $151.36 Typical High $218.78 | Facility | None | $128.82 | $151.36 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $218.78 | Professional | None | $151.36 | $151.36 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $707.95 | Facility | None | $354.81 | $363.08 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $630.96 | Professional | None | $218.78 | $218.78 | $630.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $47.86 | Professional | RR · Rental | $21.88 | $21.88 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $295.12 | Professional | UE · Used equipment | $162.18 | $162.18 | $295.12 |
CDPHP Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Emblem Health Setting Facility Modifier None Typical Low $354.81 Median $588.84 Typical High $1,288.25 | Facility | None | $354.81 | $588.84 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $630.96 | Professional | None | $234.42 | $380.19 | $630.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $295.12 | Professional | None | $151.36 | $208.93 | $295.12 |
Highmark BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
MVP Health Care Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
MVP Health Care Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $524.81 | Professional | None | $208.93 | $208.93 | $524.81 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $575.44 | Facility | None | $234.42 | $281.84 | $575.44 |
United Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $269.15 | Professional | None | $117.49 | $213.80 | $269.15 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $208.93 | Facility | None | $151.36 | $151.36 | $208.93 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $295.12 | Professional | None | $151.36 | $208.93 | $295.12 |
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 $75.86 Median $75.86 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | 53 · Discontinued | $30.20 | $30.20 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $21.88 |
Where New York sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 37th of 51
$219
HI $646TN $178
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.