How much rates vary
Facilitymedian $1,122 · 10th to 90th $1,072 to $3,548Professionalmedian $1,259 · 10th to 90th $933 to $3,020
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 $776.25 Median $933.25 Typical High $1,348.96 | Facility | None | $776.25 | $933.25 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,348.96 | Professional | None | $933.25 | $933.25 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $4,365.16 | Facility | None | $2,187.76 | $2,238.72 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $3,715.35 | Professional | None | $1,096.48 | $1,096.48 | $3,715.35 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $239.88 | Professional | RR · Rental | $109.65 | $109.65 | $239.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $1,479.11 | Professional | UE · Used equipment | $831.76 | $831.76 | $1,479.11 |
CDPHP Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Facility | None | $1,122.02 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Emblem Health Setting Facility Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $7,762.47 | Facility | None | $2,187.76 | $3,548.13 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,380.38 | $2,187.76 | $3,890.45 |
Excellus BCBS 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 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,288.25 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
MVP Health Care Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $3,162.28 | Professional | None | $1,258.93 | $1,258.93 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $2,951.21 | Facility | None | $1,047.13 | $1,202.26 | $2,951.21 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,288.25 Typical High $1,445.44 | Professional | None | $707.95 | $1,288.25 | $1,445.44 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,288.25 | Facility | None | $1,071.52 | $1,071.52 | $1,288.25 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,288.25 | $1,778.28 |
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 $467.74 Median $467.74 Typical High $676.08 | Professional | 52 · Reduced service | $467.74 | $467.74 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $269.15 | Professional | 53 · Discontinued | $186.21 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $199.53 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $134.90 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $134.90 |
Where New York sits
The same service costs 3.1 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· 24th of 51
$1,259
HI $2,692DE $871
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.