How much rates vary
Facilitymedian $49 · 10th to 90th $43 to $135Professionalmedian $54 · 10th to 90th $35 to $110
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 $28.84 Median $33.88 Typical High $48.98 | Facility | None | $28.84 | $33.88 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | None | $33.88 | $33.88 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $81.28 Typical High $158.49 | Facility | None | $79.43 | $81.28 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $134.90 | Professional | None | $53.70 | $54.95 | $134.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $5.37 Typical High $11.75 | Professional | RR · Rental | $5.37 | $5.37 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $72.44 | Professional | UE · Used equipment | $39.81 | $39.81 | $72.44 |
CDPHP Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $53.70 | Facility | None | $48.98 | $48.98 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Emblem Health Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $288.40 | Facility | None | $79.43 | $131.83 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $141.25 | Professional | None | $51.29 | $85.11 | $141.25 |
Excellus BCBS Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Excellus BCBS Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $64.57 | Professional | None | $42.66 | $46.77 | $64.57 |
MVP Health Care Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $117.49 | Professional | None | $46.77 | $46.77 | $117.49 |
United Setting Facility Modifier None Typical Low $19.95 Median $39.81 Typical High $125.89 | Facility | None | $19.95 | $39.81 | $125.89 |
United Setting Professional Modifier None Typical Low $25.70 Median $47.86 Typical High $60.26 | Professional | None | $25.70 | $47.86 | $60.26 |
Univera Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $48.98 | Facility | None | $42.66 | $42.66 | $48.98 |
Univera Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $64.57 | Professional | None | $42.66 | $46.77 | $64.57 |
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 $16.98 Median $16.98 Typical High $24.55 | Professional | 52 · Reduced service | $16.98 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $9.77 | Professional | 53 · Discontinued | $6.76 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $7.41 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $4.90 |
Where New York sits
The same service costs 2.8 times more in Montana than in New Jersey. 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· 27th of 51
$53.70
MT $107NJ $38.90
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.