How much rates vary
Facilitymedian $1,047 · 10th to 90th $933 to $2,884Professionalmedian $1,000 · 10th to 90th $832 to $2,455
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 $1,000.00 Median $1,000.00 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,000.00 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $100.00 Median $100.00 Typical High $218.78 | Professional | RR · Rental | $100.00 | $100.00 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $758.58 Median $758.58 Typical High $1,348.96 | Professional | UE · Used equipment | $758.58 | $758.58 | $1,348.96 |
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 $1,318.26 Median $1,318.26 Typical High $1,412.54 | Facility | None | $1,318.26 | $1,318.26 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,380.38 | Professional | None | $933.25 | $1,000.00 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $645.65 Median $831.76 Typical High $2,691.53 | Facility | None | $645.65 | $831.76 | $2,691.53 |
United Setting Professional Modifier None Typical Low $549.54 Median $1,023.29 Typical High $1,258.93 | Professional | None | $549.54 | $1,023.29 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Facility | None | $933.25 | $933.25 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,380.38 | Professional | None | $933.25 | $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 2.5 times more in Montana than in Pennsylvania. 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· 34th of 51
$1,000
MT $2,239PA $891
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.