How much rates vary
Facilitymedian $13,490 · 10th to 90th $9,333 to $35,481Professionalmedian $10,715 · 10th to 90th $8,511 to $26,303
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 $6,456.54 Median $7,585.78 Typical High $10,964.78 | Facility | None | $6,456.54 | $7,585.78 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $10,964.78 | Professional | None | $7,585.78 | $7,585.78 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $17,782.79 Median $18,197.01 Typical High $35,481.34 | Facility | None | $17,782.79 | $18,197.01 | $35,481.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $31,622.78 | Professional | None | $10,715.19 | $10,715.19 | $31,622.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $1,071.52 Typical High $2,344.23 | Professional | RR · Rental | $1,071.52 | $1,071.52 | $2,344.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,943.28 Median $7,943.28 Typical High $14,454.40 | Professional | UE · Used equipment | $7,943.28 | $7,943.28 | $14,454.40 |
CDPHP Setting Professional Modifier None Typical Low $14,454.40 Median $14,454.40 Typical High $14,454.40 | Professional | None | $14,454.40 | $14,454.40 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,489.63 | Facility | None | $12,589.25 | $12,589.25 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
Emblem Health Setting Facility Modifier None Typical Low $17,782.79 Median $29,512.09 Typical High $64,565.42 | Facility | None | $17,782.79 | $29,512.09 | $64,565.42 |
Emblem Health Setting Professional Modifier None Typical Low $11,481.54 Median $19,498.45 Typical High $31,622.78 | Professional | None | $11,481.54 | $19,498.45 | $31,622.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $10,000.00 Median $11,220.18 Typical High $14,454.40 | Professional | None | $10,000.00 | $11,220.18 | $14,454.40 |
MVP Health Care Setting Professional Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $26,302.68 | Professional | None | $10,471.29 | $10,471.29 | $26,302.68 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $9,332.54 Typical High $28,840.32 | Facility | None | $7,943.28 | $9,332.54 | $28,840.32 |
United Setting Professional Modifier None Typical Low $5,888.44 Median $10,715.19 Typical High $13,489.63 | Professional | None | $5,888.44 | $10,715.19 | $13,489.63 |
Univera Setting Facility Modifier None Typical Low $10,000.00 Median $10,471.29 Typical High $13,489.63 | Facility | None | $10,000.00 | $10,471.29 | $13,489.63 |
Univera Setting Professional Modifier None Typical Low $10,000.00 Median $11,220.18 Typical High $14,454.40 | Professional | None | $10,000.00 | $11,220.18 | $14,454.40 |
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 $3,801.89 Median $3,801.89 Typical High $5,495.41 | Professional | 52 · Reduced service | $3,801.89 | $3,801.89 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,513.56 Median $1,513.56 Typical High $2,187.76 | Professional | 53 · Discontinued | $1,513.56 | $1,513.56 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,148.15 Median $1,148.15 Typical High $1,659.59 | Professional | 55 · Aftercare only | $1,148.15 | $1,148.15 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $758.58 Median $758.58 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $758.58 | $758.58 | $1,096.48 |
Where New York sits
The same service costs 2.5 times more in Montana than in Florida. 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· 35th of 51
$10,715
MT $22,387FL $9,120
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.