How much rates vary
Facilitymedian $214 · 10th to 90th $178 to $589Professionalmedian $200 · 10th to 90th $151 to $457
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 $128.82 Median $151.36 Typical High $218.78 | Facility | None | $128.82 | $151.36 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $218.78 | Professional | None | $151.36 | $151.36 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $707.95 | Facility | None | $354.81 | $363.08 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $173.78 Typical High $602.56 | Professional | None | $169.82 | $173.78 | $602.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $37.15 | Professional | RR · Rental | $16.98 | $16.98 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $125.89 Typical High $229.09 | Professional | UE · Used equipment | $125.89 | $125.89 | $229.09 |
CDPHP Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $194.98 | Facility | None | $177.83 | $177.83 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $354.81 Median $588.84 Typical High $1,288.25 | Facility | None | $354.81 | $588.84 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $630.96 | Professional | None | $223.87 | $354.81 | $630.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $295.12 | Professional | None | $208.93 | $213.80 | $295.12 |
Highmark BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
MVP Health Care Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $524.81 | Professional | None | $208.93 | $208.93 | $524.81 |
United Setting Facility Modifier None Typical Low $186.21 Median $208.93 Typical High $457.09 | Facility | None | $186.21 | $208.93 | $457.09 |
United Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $239.88 | Professional | None | $117.49 | $208.93 | $239.88 |
Univera Setting Facility Modifier None Typical Low $208.93 Median $213.80 Typical High $218.78 | Facility | None | $208.93 | $213.80 | $218.78 |
Univera Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $295.12 | Professional | None | $208.93 | $213.80 | $295.12 |
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 $75.86 Median $75.86 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | 53 · Discontinued | $30.20 | $30.20 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $21.88 |
Where New York sits
The same service costs 3.5 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· 22nd of 51
$209
HI $447DE $129
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.