How much rates vary
Facilitymedian $186 · 10th to 90th $162 to $457Professionalmedian $155 · 10th to 90th $123 to $355
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 $100.00 Median $117.49 Typical High $169.82 | Facility | None | $100.00 | $117.49 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $169.82 | Professional | None | $117.49 | $117.49 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $549.54 | Facility | None | $275.42 | $281.84 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $467.74 | Professional | None | $123.03 | $128.82 | $467.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $26.92 | Professional | RR · Rental | $12.30 | $12.30 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $165.96 | Professional | UE · Used equipment | $93.33 | $93.33 | $165.96 |
CDPHP Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $190.55 | Facility | None | $169.82 | $169.82 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $457.09 Typical High $1,000.00 | Facility | None | $275.42 | $457.09 | $1,000.00 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $489.78 | Professional | None | $181.97 | $275.42 | $489.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $229.09 | Professional | None | $162.18 | $186.21 | $229.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
MVP Health Care Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
MVP Health Care Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $407.38 | Professional | None | $162.18 | $162.18 | $407.38 |
United Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $331.13 | Facility | None | $107.15 | $134.90 | $331.13 |
United Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $181.97 | Professional | None | $91.20 | $154.88 | $181.97 |
Univera Setting Facility Modifier None Typical Low $162.18 Median $186.21 Typical High $186.21 | Facility | None | $162.18 | $186.21 | $186.21 |
Univera Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $229.09 | Professional | None | $162.18 | $186.21 | $229.09 |
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 $58.88 Median $58.88 Typical High $85.11 | Professional | 52 · Reduced service | $58.88 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $34.67 | Professional | 53 · Discontinued | $23.44 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $25.70 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $16.98 |
Where New York sits
The same service costs 2.7 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· 21st of 51
$158
HI $295DC $110
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.