How much rates vary
Facilitymedian $4,677 · 10th to 90th $3,548 to $14,454Professionalmedian $4,266 · 10th to 90th $3,388 to $10,715
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 $2,570.40 Median $3,090.30 Typical High $4,466.84 | Facility | None | $2,570.40 | $3,090.30 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $4,466.84 | Professional | None | $3,090.30 | $3,090.30 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $14,454.40 | Facility | None | $7,244.36 | $7,244.36 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $12,589.25 | Professional | None | $4,265.80 | $4,265.80 | $12,589.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $426.58 Median $426.58 Typical High $933.25 | Professional | RR · Rental | $426.58 | $426.58 | $933.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,235.94 Median $3,235.94 Typical High $5,754.40 | Professional | UE · Used equipment | $3,235.94 | $3,235.94 | $5,754.40 |
CDPHP Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,011.87 | Facility | None | $4,677.35 | $4,677.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Emblem Health Setting Facility Modifier None Typical Low $7,244.36 Median $11,748.98 Typical High $25,703.96 | Facility | None | $7,244.36 | $11,748.98 | $25,703.96 |
Emblem Health Setting Professional Modifier None Typical Low $4,677.35 Median $7,585.78 Typical High $12,589.25 | Professional | None | $4,677.35 | $7,585.78 | $12,589.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $5,888.44 | Professional | None | $4,073.80 | $4,466.84 | $5,888.44 |
MVP Health Care Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $10,471.29 | Professional | None | $4,168.69 | $4,168.69 | $10,471.29 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $11,481.54 | Facility | None | $2,884.03 | $3,548.13 | $11,481.54 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $4,265.80 Typical High $5,370.32 | Professional | None | $2,344.23 | $4,265.80 | $5,370.32 |
Univera Setting Facility Modifier None Typical Low $4,073.80 Median $4,265.80 Typical High $4,365.16 | Facility | None | $4,073.80 | $4,265.80 | $4,365.16 |
Univera Setting Professional Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $5,888.44 | Professional | None | $4,073.80 | $4,466.84 | $5,888.44 |
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 $1,548.82 Median $1,548.82 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $891.25 | Professional | 53 · Discontinued | $616.60 | $616.60 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $660.69 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $446.68 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $446.68 |
Where New York sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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
$4,266
AR $8,128VT $3,467
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.