How much rates vary
Facilitymedian $35 · 10th to 90th $35 to $107Professionalmedian $35 · 10th to 90th $28 to $87
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 $23.44 Median $27.54 Typical High $40.74 | Facility | None | $23.44 | $27.54 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $40.74 | Professional | None | $27.54 | $27.54 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $64.57 Median $66.07 Typical High $131.83 | Facility | None | $64.57 | $66.07 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $109.65 | Professional | None | $33.11 | $34.67 | $109.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $7.24 | Professional | RR · Rental | $3.31 | $3.31 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $50.12 | Professional | UE · Used equipment | $25.12 | $25.12 | $50.12 |
CDPHP Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $38.02 | Facility | None | $34.67 | $34.67 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $107.15 Typical High $234.42 | Facility | None | $64.57 | $107.15 | $234.42 |
Emblem Health Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $114.82 | Professional | None | $40.74 | $69.18 | $114.82 |
Excellus BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $53.70 | Professional | None | $35.48 | $38.90 | $53.70 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
MVP Health Care Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $95.50 | Professional | None | $38.02 | $38.02 | $95.50 |
United Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $91.20 | Facility | None | $27.54 | $29.51 | $91.20 |
United Setting Professional Modifier None Typical Low $21.38 Median $38.90 Typical High $43.65 | Professional | None | $21.38 | $38.90 | $43.65 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $39.81 | Facility | None | $35.48 | $35.48 | $39.81 |
Univera Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $53.70 | Professional | None | $35.48 | $38.90 | $53.70 |
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 $13.80 Median $13.80 Typical High $19.95 | Professional | 52 · Reduced service | $13.80 | $13.80 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | 53 · Discontinued | $5.62 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $6.03 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $4.07 |
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· 27th of 51
$35.48
HI $64.57DE $25.70
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.