How much rates vary
Facilitymedian $11,749 · 10th to 90th $8,913 to $34,674Professionalmedian $10,233 · 10th to 90th $8,128 to $25,704
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 $6,309.57 Median $7,413.10 Typical High $10,715.19 | Facility | None | $6,309.57 | $7,413.10 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $10,715.19 | Professional | None | $7,413.10 | $7,413.10 | $10,715.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $17,378.01 Median $17,782.79 Typical High $34,673.69 | Facility | None | $17,378.01 | $17,782.79 | $34,673.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $30,199.52 | Professional | None | $10,232.93 | $10,232.93 | $30,199.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,023.29 Median $1,023.29 Typical High $2,238.72 | Professional | RR · Rental | $1,023.29 | $1,023.29 | $2,238.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,762.47 Median $7,762.47 Typical High $13,803.84 | Professional | UE · Used equipment | $7,762.47 | $7,762.47 | $13,803.84 |
CDPHP Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,125.38 | Professional | None | $14,125.38 | $14,125.38 | $14,125.38 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,882.50 | Facility | None | $11,748.98 | $11,748.98 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
Emblem Health Setting Facility Modifier None Typical Low $17,378.01 Median $28,840.32 Typical High $63,095.73 | Facility | None | $17,378.01 | $28,840.32 | $63,095.73 |
Emblem Health Setting Professional Modifier None Typical Low $11,220.18 Median $19,054.61 Typical High $30,902.95 | Professional | None | $11,220.18 | $19,054.61 | $30,902.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $9,772.37 Median $10,964.78 Typical High $14,125.38 | Professional | None | $9,772.37 | $10,964.78 | $14,125.38 |
MVP Health Care Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $25,118.86 | Professional | None | $10,232.93 | $10,232.93 | $25,118.86 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $8,912.51 Typical High $27,542.29 | Facility | None | $7,585.78 | $8,912.51 | $27,542.29 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $10,471.29 Typical High $13,182.57 | Professional | None | $5,623.41 | $10,471.29 | $13,182.57 |
Univera Setting Facility Modifier None Typical Low $9,772.37 Median $10,232.93 Typical High $10,715.19 | Facility | None | $9,772.37 | $10,232.93 | $10,715.19 |
Univera Setting Professional Modifier None Typical Low $9,772.37 Median $10,964.78 Typical High $14,125.38 | Professional | None | $9,772.37 | $10,964.78 | $14,125.38 |
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 $3,715.35 Median $3,715.35 Typical High $5,370.32 | Professional | 52 · Reduced service | $3,715.35 | $3,715.35 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,479.11 Median $1,479.11 Typical High $2,137.96 | Professional | 53 · Discontinued | $1,479.11 | $1,479.11 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,122.02 Median $1,122.02 Typical High $1,621.81 | Professional | 55 · Aftercare only | $1,122.02 | $1,122.02 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $741.31 Median $741.31 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $741.31 | $741.31 | $1,071.52 |
Where New York sits
The same service costs 2.6 times more in Montana 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· 38th of 51
$10,233
MT $21,878NJ $8,511
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.