How much rates vary
Facilitymedian $479 · 10th to 90th $282 to $1,288Professionalmedian $457 · 10th to 90th $324 to $1,122
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 $275.42 Median $323.59 Typical High $478.63 | Facility | None | $275.42 | $323.59 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $478.63 | Professional | None | $323.59 | $323.59 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $1,548.82 | Facility | None | $758.58 | $776.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,348.96 | Professional | None | $457.09 | $457.09 | $1,348.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $100.00 | Professional | RR · Rental | $45.71 | $45.71 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $616.60 | Professional | UE · Used equipment | $346.74 | $346.74 | $616.60 |
CDPHP Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Facility | None | $645.65 | $645.65 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $1,258.93 Typical High $2,754.23 | Facility | None | $758.58 | $1,258.93 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $1,348.96 | Professional | None | $489.78 | $812.83 | $1,348.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $630.96 | Professional | None | $281.84 | $446.68 | $630.96 |
MVP Health Care Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
MVP Health Care Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $1,122.02 | Professional | None | $446.68 | $446.68 | $1,122.02 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,023.29 Typical High $1,318.26 | Facility | None | $489.78 | $1,023.29 | $1,318.26 |
United Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $575.44 | Professional | None | $251.19 | $457.09 | $575.44 |
Univera Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $446.68 | Facility | None | $281.84 | $281.84 | $446.68 |
Univera Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $630.96 | Professional | None | $281.84 | $446.68 | $630.96 |
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 $162.18 Median $162.18 Typical High $234.42 | Professional | 52 · Reduced service | $162.18 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $95.50 | Professional | 53 · Discontinued | $66.07 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $70.79 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $47.86 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $47.86 |
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· 48th of 51
$457
HI $1,096DC $407
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.