How much rates vary
Facilitymedian $7,244 · 10th to 90th $5,129 to $19,055Professionalmedian $5,623 · 10th to 90th $4,467 to $14,125
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 $3,388.44 Median $3,981.07 Typical High $5,888.44 | Facility | None | $3,388.44 | $3,981.07 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,888.44 | Professional | None | $3,981.07 | $3,981.07 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $9,549.93 Typical High $19,054.61 | Facility | None | $9,332.54 | $9,549.93 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $16,595.87 | Professional | None | $5,623.41 | $5,623.41 | $16,595.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $1,230.27 | Professional | RR · Rental | $562.34 | $562.34 | $1,230.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $4,265.80 Typical High $7,585.78 | Professional | UE · Used equipment | $4,265.80 | $4,265.80 | $7,585.78 |
CDPHP Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,762.47 | Facility | None | $7,244.36 | $7,244.36 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Emblem Health Setting Facility Modifier None Typical Low $9,332.54 Median $15,488.17 Typical High $33,884.42 | Facility | None | $9,332.54 | $15,488.17 | $33,884.42 |
Emblem Health Setting Professional Modifier None Typical Low $6,165.95 Median $10,471.29 Typical High $16,595.87 | Professional | None | $6,165.95 | $10,471.29 | $16,595.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $7,762.47 | Professional | None | $5,248.07 | $5,888.44 | $7,762.47 |
MVP Health Care Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $13,803.84 | Professional | None | $5,495.41 | $5,495.41 | $13,803.84 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $15,135.61 | Facility | None | $4,365.16 | $5,128.61 | $15,135.61 |
United Setting Professional Modifier None Typical Low $3,090.30 Median $5,623.41 Typical High $7,079.46 | Professional | None | $3,090.30 | $5,623.41 | $7,079.46 |
Univera Setting Facility Modifier None Typical Low $5,248.07 Median $5,623.41 Typical High $5,754.40 | Facility | None | $5,248.07 | $5,623.41 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $7,762.47 | Professional | None | $5,248.07 | $5,888.44 | $7,762.47 |
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 $1,995.26 Median $1,995.26 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $1,174.90 | Professional | 53 · Discontinued | $812.83 | $812.83 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $870.96 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $588.84 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $588.84 |
Where New York sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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
$5,623
HI $11,220NJ $5,248
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.