How much rates vary
Facilitymedian $263 · 10th to 90th $178 to $759Professionalmedian $269 · 10th to 90th $191 to $646
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 $162.18 Median $190.55 Typical High $275.42 | Facility | None | $162.18 | $190.55 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $275.42 | Professional | None | $190.55 | $190.55 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $457.09 Typical High $891.25 | Facility | None | $446.68 | $457.09 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $794.33 | Professional | None | $269.15 | $269.15 | $794.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $58.88 | Professional | RR · Rental | $26.92 | $26.92 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $204.17 Median $204.17 Typical High $363.08 | Professional | UE · Used equipment | $204.17 | $204.17 | $363.08 |
CDPHP Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Emblem Health Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,621.81 | Facility | None | $446.68 | $741.31 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $794.33 | Professional | None | $295.12 | $478.63 | $794.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $363.08 | Professional | None | $177.83 | $263.03 | $363.08 |
MVP Health Care Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
MVP Health Care Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $660.69 | Professional | None | $263.03 | $263.03 | $660.69 |
United Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $724.44 | Facility | None | $213.80 | $257.04 | $724.44 |
United Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $338.84 | Professional | None | $147.91 | $269.15 | $338.84 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $263.03 | Facility | None | $177.83 | $177.83 | $263.03 |
Univera Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $363.08 | Professional | None | $177.83 | $263.03 | $363.08 |
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 $95.50 Median $95.50 Typical High $138.04 | Professional | 52 · Reduced service | $95.50 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $27.54 |
Where New York sits
The same service costs 2.5 times more in Hawaii 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· 38th of 51
$269
HI $562DE $229
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.