How much rates vary
Facilitymedian $6,607 · 10th to 90th $4,467 to $16,218Professionalmedian $4,898 · 10th to 90th $3,890 to $12,023
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 $2,951.21 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,951.21 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $5,011.87 | Professional | None | $3,467.37 | $3,467.37 | $5,011.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $8,317.64 Typical High $16,218.10 | Facility | None | $8,128.31 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $14,454.40 | Professional | None | $4,897.79 | $4,897.79 | $14,454.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $1,071.52 | Professional | RR · Rental | $489.78 | $489.78 | $1,071.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,630.78 Typical High $6,606.93 | Professional | UE · Used equipment | $3,630.78 | $3,630.78 | $6,606.93 |
CDPHP Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,079.46 | Facility | None | $6,606.93 | $6,606.93 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $8,128.31 Median $13,489.63 Typical High $29,512.09 | Facility | None | $8,128.31 | $13,489.63 | $29,512.09 |
Emblem Health Setting Professional Modifier None Typical Low $5,370.32 Median $8,912.51 Typical High $14,454.40 | Professional | None | $5,370.32 | $8,912.51 | $14,454.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $4,570.88 Median $5,128.61 Typical High $6,606.93 | Professional | None | $4,570.88 | $5,128.61 | $6,606.93 |
MVP Health Care Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $12,022.64 | Professional | None | $4,786.30 | $4,786.30 | $12,022.64 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $13,182.57 | Facility | None | $3,801.89 | $4,466.84 | $13,182.57 |
United Setting Professional Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $6,165.95 | Professional | None | $2,691.53 | $4,897.79 | $6,165.95 |
Univera Setting Facility Modifier None Typical Low $4,570.88 Median $4,786.30 Typical High $5,011.87 | Facility | None | $4,570.88 | $4,786.30 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $4,570.88 Median $5,128.61 Typical High $6,606.93 | Professional | None | $4,570.88 | $5,128.61 | $6,606.93 |
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 $1,737.80 Median $1,737.80 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $1,000.00 | Professional | 53 · Discontinued | $691.83 | $691.83 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $758.58 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $501.19 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $501.19 |
Where New York sits
The same service costs 2.1 times more in Montana 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· 36th of 51
$4,898
MT $10,000PA $4,786
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.