How much rates vary
Facilitymedian $126 · 10th to 90th $66 to $437Professionalmedian $148 · 10th to 90th $93 to $355
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 $93.33 Median $112.20 Typical High $162.18 | Facility | None | $93.33 | $112.20 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | None | $112.20 | $112.20 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $524.81 | Facility | None | $263.03 | $269.15 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $446.68 | Professional | None | $117.49 | $117.49 | $446.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $11.75 Typical High $25.70 | Professional | RR · Rental | $11.75 | $11.75 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $173.78 | Professional | UE · Used equipment | $89.13 | $89.13 | $173.78 |
CDPHP Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $141.25 | Facility | None | $125.89 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Emblem Health Setting Facility Modifier None Typical Low $263.03 Median $436.52 Typical High $954.99 | Facility | None | $263.03 | $436.52 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $467.74 | Professional | None | $165.96 | $275.42 | $467.74 |
Excellus BCBS Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $213.80 | Professional | None | $66.07 | $154.88 | $213.80 |
MVP Health Care Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
MVP Health Care Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $380.19 | Professional | None | $151.36 | $151.36 | $380.19 |
United Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $316.23 | Facility | None | $100.00 | $120.23 | $316.23 |
United Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $169.82 | Professional | None | $85.11 | $144.54 | $169.82 |
Univera Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $154.88 | Facility | None | $66.07 | $66.07 | $154.88 |
Univera Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $213.80 | Professional | None | $66.07 | $154.88 | $213.80 |
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 $56.23 Median $56.23 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $32.36 | Professional | 53 · Discontinued | $22.39 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $24.55 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $16.22 |
Where New York sits
The same service costs 2.9 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· 20th of 51
$148
HI $269FL $93.33
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.