How much rates vary
Facilitymedian $132 · 10th to 90th $107 to $372Professionalmedian $138 · 10th to 90th $107 to $309
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 $81.28 Median $95.50 Typical High $138.04 | Facility | None | $81.28 | $95.50 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | None | $95.50 | $95.50 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $229.09 Typical High $446.68 | Facility | None | $223.87 | $229.09 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $141.25 Typical High $380.19 | Professional | None | $138.04 | $141.25 | $380.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $30.20 | Professional | RR · Rental | $13.80 | $13.80 | $30.20 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $194.98 | Facility | None | $173.78 | $173.78 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $371.54 Typical High $812.83 | Facility | None | $223.87 | $371.54 | $812.83 |
Emblem Health Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $398.11 | Professional | None | $141.25 | $223.87 | $398.11 |
Excellus BCBS Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $181.97 | Professional | None | $107.15 | $131.83 | $181.97 |
Highmark BCBS Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
MVP Health Care Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
MVP Health Care Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $331.13 | Professional | None | $131.83 | $131.83 | $331.13 |
United Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $338.84 | Facility | None | $85.11 | $109.65 | $338.84 |
United Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $158.49 | Professional | None | $74.13 | $134.90 | $158.49 |
Univera Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
Univera Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $181.97 | Professional | None | $107.15 | $131.83 | $181.97 |
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 $47.86 Median $47.86 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $27.54 | Professional | 53 · Discontinued | $19.05 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $20.89 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $13.80 |
Where New York sits
The same service costs 2.0 times more in Wisconsin than in Delaware. 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· 30th of 51
$138
WI $257DE $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.