How much rates vary
Facilitymedian $724 · 10th to 90th $562 to $1,585Professionalmedian $562 · 10th to 90th $447 to $1,349
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 $338.84 Median $407.38 Typical High $588.84 | Facility | None | $338.84 | $407.38 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $588.84 | Professional | None | $407.38 | $407.38 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,905.46 | Facility | None | $954.99 | $954.99 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,621.81 | Professional | None | $501.19 | $501.19 | $1,621.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $109.65 | Professional | RR · Rental | $50.12 | $50.12 | $109.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $380.19 Median $380.19 Typical High $676.08 | Professional | UE · Used equipment | $380.19 | $380.19 | $676.08 |
CDPHP Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $776.25 | Facility | None | $691.83 | $691.83 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $3,388.44 | Facility | None | $954.99 | $1,548.82 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,659.59 | Professional | None | $616.60 | $954.99 | $1,659.59 |
Excellus BCBS Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $776.25 | Professional | None | $562.34 | $724.44 | $776.25 |
MVP Health Care Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
MVP Health Care Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,380.38 | Professional | None | $549.54 | $549.54 | $1,380.38 |
United Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $1,348.96 | Facility | None | $398.11 | $501.19 | $1,348.96 |
United Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $645.65 | Professional | None | $309.03 | $562.34 | $645.65 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $724.44 | Facility | None | $562.34 | $724.44 | $724.44 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $776.25 | Professional | None | $562.34 | $724.44 | $776.25 |
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 $199.53 Median $199.53 Typical High $295.12 | Professional | 52 · Reduced service | $199.53 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $58.88 |
Where New York sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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
$562
HI $1,122DC $468
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.