How much rates vary
Facilitymedian $437 · 10th to 90th $275 to $1,202Professionalmedian $417 · 10th to 90th $302 to $1,023
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 $257.04 Median $302.00 Typical High $436.52 | Facility | None | $257.04 | $302.00 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $436.52 | Professional | None | $302.00 | $302.00 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,412.54 | Facility | None | $707.95 | $724.44 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,230.27 | Professional | None | $416.87 | $416.87 | $1,230.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $91.20 | Professional | RR · Rental | $41.69 | $41.69 | $91.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $562.34 | Professional | UE · Used equipment | $309.03 | $309.03 | $562.34 |
CDPHP Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Emblem Health Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $2,570.40 | Facility | None | $707.95 | $1,174.90 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,258.93 | Professional | None | $457.09 | $741.31 | $1,258.93 |
Excellus BCBS Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $575.44 | Professional | None | $275.42 | $416.87 | $575.44 |
MVP Health Care Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
MVP Health Care Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $1,023.29 | Professional | None | $416.87 | $416.87 | $1,023.29 |
United Setting Facility Modifier None Typical Low $426.58 Median $467.74 Typical High $1,122.02 | Facility | None | $426.58 | $467.74 | $1,122.02 |
United Setting Professional Modifier None Typical Low $229.09 Median $426.58 Typical High $537.03 | Professional | None | $229.09 | $426.58 | $537.03 |
Univera Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $416.87 | Facility | None | $275.42 | $275.42 | $416.87 |
Univera Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $575.44 | Professional | None | $275.42 | $416.87 | $575.44 |
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 $151.36 Median $151.36 Typical High $218.78 | Professional | 52 · Reduced service | $151.36 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | 53 · Discontinued | $60.26 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $43.65 |
Where New York sits
The same service costs 3.0 times more in Hawaii than in West Virginia. 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· 38th of 51
$417
HI $1,072WV $363
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.