How much rates vary
Facilitymedian $195 · 10th to 90th $182 to $501Professionalmedian $182 · 10th to 90th $135 to $417
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 $109.65 Median $131.83 Typical High $190.55 | Facility | None | $109.65 | $131.83 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $190.55 | Professional | None | $131.83 | $131.83 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $616.60 | Facility | None | $309.03 | $309.03 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $512.86 | Professional | None | $138.04 | $138.04 | $512.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $29.51 | Professional | RR · Rental | $13.80 | $13.80 | $29.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $186.21 | Professional | UE · Used equipment | $102.33 | $102.33 | $186.21 |
CDPHP Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $213.80 | Facility | None | $194.98 | $194.98 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Emblem Health Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $1,096.48 | Facility | None | $309.03 | $501.19 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $537.03 | Professional | None | $194.98 | $309.03 | $537.03 |
Excellus BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $251.19 | Professional | None | $181.97 | $194.98 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
MVP Health Care Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $446.68 | Professional | None | $177.83 | $177.83 | $446.68 |
United Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $371.54 | Facility | None | $151.36 | $158.49 | $371.54 |
United Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $199.53 | Professional | None | $100.00 | $169.82 | $199.53 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $194.98 Typical High $194.98 | Facility | None | $181.97 | $194.98 | $194.98 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $251.19 | Professional | None | $181.97 | $194.98 | $251.19 |
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 $64.57 Median $64.57 Typical High $95.50 | Professional | 52 · Reduced service | $64.57 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $38.02 | Professional | 53 · Discontinued | $26.30 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $28.18 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $19.05 |
Where New York sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 17th of 51
$182
HI $407DC $129
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.