How much rates vary
Facilitymedian $1,000 · 10th to 90th $708 to $2,818Professionalmedian $1,000 · 10th to 90th $708 to $2,344
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 $616.60 Median $724.44 Typical High $1,047.13 | Facility | None | $616.60 | $724.44 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,047.13 | Professional | None | $724.44 | $724.44 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $3,388.44 | Facility | None | $1,698.24 | $1,737.80 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $2,884.03 | Professional | None | $851.14 | $851.14 | $2,884.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $85.11 Median $85.11 Typical High $181.97 | Professional | RR · Rental | $85.11 | $85.11 | $181.97 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $630.96 Median $630.96 Typical High $1,122.02 | Professional | UE · Used equipment | $630.96 | $630.96 | $1,122.02 |
CDPHP Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Facility | None | $1,096.48 | $1,096.48 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Emblem Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $6,165.95 | Facility | None | $1,698.24 | $2,818.38 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,778.28 | $3,019.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,380.38 | Professional | None | $707.95 | $1,000.00 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
MVP Health Care Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,000.00 | $2,454.71 |
United Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,238.72 | Facility | None | $660.69 | $776.25 | $2,238.72 |
United Setting Professional Modifier None Typical Low $549.54 Median $977.24 Typical High $1,122.02 | Professional | None | $549.54 | $977.24 | $1,122.02 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $1,000.00 | Facility | None | $707.95 | $707.95 | $1,000.00 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,380.38 | Professional | None | $707.95 | $1,000.00 | $1,380.38 |
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 $363.08 Median $363.08 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $363.08 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $104.71 |
Where New York sits
The same service costs 2.2 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· 23rd of 51
$1,000
HI $1,778FL $813
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.