How much rates vary
Facilitymedian $7,586 · 10th to 90th $4,786 to $19,055Professionalmedian $6,607 · 10th to 90th $4,677 to $13,804
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 $3,467.37 Median $4,073.80 Typical High $5,888.44 | Facility | None | $3,467.37 | $4,073.80 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,888.44 | Professional | None | $4,073.80 | $4,073.80 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,549.93 Median $9,772.37 Typical High $19,054.61 | Facility | None | $9,549.93 | $9,772.37 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,606.93 Median $6,760.83 Typical High $16,218.10 | Professional | None | $6,606.93 | $6,760.83 | $16,218.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $660.69 Median $660.69 Typical High $1,412.54 | Professional | RR · Rental | $660.69 | $660.69 | $1,412.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,897.79 Median $4,897.79 Typical High $8,709.64 | Professional | UE · Used equipment | $4,897.79 | $4,897.79 | $8,709.64 |
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 $7,585.78 Median $7,585.78 Typical High $8,317.64 | Facility | None | $7,585.78 | $7,585.78 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Emblem Health Setting Facility Modifier None Typical Low $9,549.93 Median $15,848.93 Typical High $34,673.69 | Facility | None | $9,549.93 | $15,848.93 | $34,673.69 |
Emblem Health Setting Professional Modifier None Typical Low $6,309.57 Median $10,471.29 Typical High $16,982.44 | Professional | None | $6,309.57 | $10,471.29 | $16,982.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $5,370.32 Median $6,025.60 Typical High $7,762.47 | Professional | None | $5,370.32 | $6,025.60 | $7,762.47 |
Highmark BCBS Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
MVP Health Care Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $14,125.38 | Professional | None | $5,623.41 | $5,623.41 | $14,125.38 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $15,488.17 | Facility | None | $4,265.80 | $4,786.30 | $15,488.17 |
United Setting Professional Modifier None Typical Low $3,162.28 Median $5,754.40 Typical High $7,244.36 | Professional | None | $3,162.28 | $5,754.40 | $7,244.36 |
Univera Setting Facility Modifier None Typical Low $5,370.32 Median $5,623.41 Typical High $5,888.44 | Facility | None | $5,370.32 | $5,623.41 | $5,888.44 |
Univera Setting Professional Modifier None Typical Low $5,370.32 Median $6,025.60 Typical High $7,762.47 | Professional | None | $5,370.32 | $6,025.60 | $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 $2,041.74 Median $2,041.74 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,951.21 |
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 $616.60 Median $616.60 Typical High $891.25 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $588.84 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $588.84 |
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· 28th of 51
$6,607
MT $11,220PA $5,370
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.