How much rates vary
Facilitymedian $50 · 10th to 90th $37 to $151Professionalmedian $52 · 10th to 90th $37 to $126
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 $33.11 Median $39.81 Typical High $57.54 | Facility | None | $33.11 | $39.81 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $57.54 | Professional | None | $39.81 | $39.81 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $186.21 | Facility | None | $93.33 | $95.50 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $158.49 | Professional | None | $51.29 | $52.48 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.13 Median $5.13 Typical High $10.96 | Professional | RR · Rental | $5.13 | $5.13 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $69.18 | Professional | UE · Used equipment | $38.02 | $38.02 | $69.18 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $56.23 | Facility | None | $50.12 | $50.12 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Emblem Health Setting Facility Modifier None Typical Low $93.33 Median $151.36 Typical High $331.13 | Facility | None | $93.33 | $151.36 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $162.18 | Professional | None | $58.88 | $93.33 | $162.18 |
Excellus BCBS Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $75.86 | Professional | None | $37.15 | $54.95 | $75.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
MVP Health Care Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
MVP Health Care Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $134.90 | Professional | None | $53.70 | $53.70 | $134.90 |
United Setting Facility Modifier None Typical Low $32.36 Median $38.90 Typical High $125.89 | Facility | None | $32.36 | $38.90 | $125.89 |
United Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $61.66 | Professional | None | $30.20 | $54.95 | $61.66 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $54.95 | Facility | None | $37.15 | $37.15 | $54.95 |
Univera Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $75.86 | Professional | None | $37.15 | $54.95 | $75.86 |
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 $19.95 Median $19.95 Typical High $28.84 | Professional | 52 · Reduced service | $19.95 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $11.48 | Professional | 53 · Discontinued | $7.94 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $8.51 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.75 |
Where New York sits
The same service costs 2.1 times more in Arkansas than in Colorado. 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· 28th of 51
$52.48
AR $85.11CO $39.81
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.