How much rates vary
Facilitymedian $302 · 10th to 90th $288 to $813Professionalmedian $288 · 10th to 90th $219 to $676
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 $177.83 Median $208.93 Typical High $302.00 | Facility | None | $177.83 | $208.93 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $302.00 | Professional | None | $208.93 | $208.93 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $501.19 Typical High $977.24 | Facility | None | $489.78 | $501.19 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $831.76 | Professional | None | $245.47 | $245.47 | $831.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $53.70 | Professional | RR · Rental | $24.55 | $24.55 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $331.13 | Professional | UE · Used equipment | $181.97 | $181.97 | $331.13 |
CDPHP Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $323.59 | Facility | None | $302.00 | $302.00 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $812.83 Typical High $1,778.28 | Facility | None | $489.78 | $812.83 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $870.96 | Professional | None | $309.03 | $489.78 | $870.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $398.11 | Professional | None | $288.40 | $295.12 | $398.11 |
MVP Health Care Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
MVP Health Care Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $707.95 | Professional | None | $288.40 | $288.40 | $707.95 |
United Setting Facility Modifier None Typical Low $251.19 Median $549.54 Typical High $724.44 | Facility | None | $251.19 | $549.54 | $724.44 |
United Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $323.59 | Professional | None | $158.49 | $288.40 | $323.59 |
Univera Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $302.00 | Facility | None | $288.40 | $295.12 | $302.00 |
Univera Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $398.11 | Professional | None | $288.40 | $295.12 | $398.11 |
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 $104.71 Median $104.71 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | 53 · Discontinued | $41.69 | $41.69 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $30.20 |
Where New York sits
The same service costs 2.5 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· 28th of 51
$288
HI $550PA $219
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.