How much rates vary
Facilitymedian $501 · 10th to 90th $389 to $1,122Professionalmedian $417 · 10th to 90th $324 to $912
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 $239.88 Median $281.84 Typical High $416.87 | Facility | None | $239.88 | $281.84 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $416.87 | Professional | None | $281.84 | $281.84 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $1,348.96 | Facility | None | $660.69 | $676.08 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $1,122.02 | Professional | None | $407.38 | $426.58 | $1,122.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $89.13 | Professional | RR · Rental | $40.74 | $40.74 | $89.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $549.54 | Professional | UE · Used equipment | $309.03 | $309.03 | $549.54 |
CDPHP Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $588.84 | Facility | None | $524.81 | $524.81 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $660.69 Median $1,096.48 Typical High $2,398.83 | Facility | None | $660.69 | $1,096.48 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $1,174.90 | Professional | None | $436.52 | $707.95 | $1,174.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $549.54 | Professional | None | $389.05 | $501.19 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
MVP Health Care Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $977.24 | Professional | None | $389.05 | $389.05 | $977.24 |
United Setting Facility Modifier None Typical Low $302.00 Median $380.19 Typical High $1,047.13 | Facility | None | $302.00 | $380.19 | $1,047.13 |
United Setting Professional Modifier None Typical Low $218.78 Median $398.11 Typical High $489.78 | Professional | None | $218.78 | $398.11 | $489.78 |
Univera Setting Facility Modifier None Typical Low $389.05 Median $501.19 Typical High $501.19 | Facility | None | $389.05 | $501.19 | $501.19 |
Univera Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $549.54 | Professional | None | $389.05 | $501.19 | $549.54 |
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 $141.25 Median $141.25 Typical High $204.17 | Professional | 52 · Reduced service | $141.25 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $83.18 | Professional | 53 · Discontinued | $57.54 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $41.69 |
Where New York sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 30th of 51
$417
HI $851PA $363
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.