How much rates vary
Facilitymedian $145 · 10th to 90th $117 to $407Professionalmedian $132 · 10th to 90th $117 to $331
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 $89.13 Median $104.71 Typical High $151.36 | Facility | None | $89.13 | $104.71 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $151.36 | Professional | None | $104.71 | $104.71 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $489.78 | Facility | None | $245.47 | $251.19 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $416.87 | Professional | None | $125.89 | $131.83 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $27.54 | Professional | RR · Rental | $12.59 | $12.59 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $95.50 Typical High $169.82 | Professional | UE · Used equipment | $95.50 | $95.50 | $169.82 |
CDPHP Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $186.21 | Facility | None | $165.96 | $165.96 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Emblem Health Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $891.25 | Facility | None | $245.47 | $407.38 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $436.52 | Professional | None | $154.88 | $245.47 | $436.52 |
Excellus BCBS Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $204.17 | Professional | None | $117.49 | $144.54 | $204.17 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $363.08 | Professional | None | $144.54 | $144.54 | $363.08 |
United Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $346.74 | Facility | None | $138.04 | $141.25 | $346.74 |
United Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $165.96 | Professional | None | $81.28 | $147.91 | $165.96 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $144.54 | Facility | None | $117.49 | $117.49 | $144.54 |
Univera Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $204.17 | Professional | None | $117.49 | $144.54 | $204.17 |
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 $52.48 Median $52.48 Typical High $75.86 | Professional | 52 · Reduced service | $52.48 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $30.90 | Professional | 53 · Discontinued | $20.89 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $22.91 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $15.14 |
Where New York sits
The same service costs 2.8 times more in Hawaii than in Florida. 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· 32nd of 51
$132
HI $331FL $120
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.