How much rates vary
Facilitymedian $43,652 · 10th to 90th $25,704 to $87,096Professionalmedian $25,704 · 10th to 90th $19,498 to $64,565
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 $15,848.93 Median $18,620.87 Typical High $26,915.35 | Facility | None | $15,848.93 | $18,620.87 | $26,915.35 |
Aetna Setting Professional Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $26,915.35 | Professional | None | $18,620.87 | $18,620.87 | $26,915.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $43,651.58 Median $44,668.36 Typical High $87,096.36 | Facility | None | $43,651.58 | $44,668.36 | $87,096.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $23,988.33 Median $23,988.33 Typical High $75,857.76 | Professional | None | $23,988.33 | $23,988.33 | $75,857.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $2,398.83 Typical High $5,248.07 | Professional | RR · Rental | $2,398.83 | $2,398.83 | $5,248.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17,782.79 Median $17,782.79 Typical High $32,359.37 | Professional | UE · Used equipment | $17,782.79 | $17,782.79 | $32,359.37 |
CDPHP Setting Professional Modifier None Typical Low $36,307.81 Median $36,307.81 Typical High $36,307.81 | Professional | None | $36,307.81 | $36,307.81 | $36,307.81 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $33,884.42 | Facility | None | $30,199.52 | $30,199.52 | $33,884.42 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $22,387.21 | Professional | None | $22,387.21 | $22,387.21 | $22,387.21 |
Emblem Health Setting Facility Modifier None Typical Low $43,651.58 Median $66,069.34 Typical High $158,489.32 | Facility | None | $43,651.58 | $66,069.34 | $158,489.32 |
Emblem Health Setting Professional Modifier None Typical Low $28,840.32 Median $45,708.82 Typical High $77,624.71 | Professional | None | $28,840.32 | $45,708.82 | $77,624.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $24,547.09 Median $27,542.29 Typical High $36,307.81 | Professional | None | $24,547.09 | $27,542.29 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $25,703.96 Median $25,703.96 Typical High $64,565.42 | Professional | None | $25,703.96 | $25,703.96 | $64,565.42 |
United Setting Facility Modifier None Typical Low $53,703.18 Median $53,703.18 Typical High $69,183.10 | Facility | None | $53,703.18 | $53,703.18 | $69,183.10 |
United Setting Professional Modifier None Typical Low $14,454.40 Median $26,302.68 Typical High $30,199.52 | Professional | None | $14,454.40 | $26,302.68 | $30,199.52 |
Univera Setting Facility Modifier None Typical Low $24,547.09 Median $25,703.96 Typical High $26,915.35 | Facility | None | $24,547.09 | $25,703.96 | $26,915.35 |
Univera Setting Professional Modifier None Typical Low $24,547.09 Median $27,542.29 Typical High $36,307.81 | Professional | None | $24,547.09 | $27,542.29 | $36,307.81 |
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 $9,332.54 Median $9,332.54 Typical High $13,489.63 | Professional | 52 · Reduced service | $9,332.54 | $9,332.54 | $13,489.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,715.35 Median $3,715.35 Typical High $5,495.41 | Professional | 53 · Discontinued | $3,715.35 | $3,715.35 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,818.38 Median $2,818.38 Typical High $4,073.80 | Professional | 55 · Aftercare only | $2,818.38 | $2,818.38 | $4,073.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,862.09 Median $1,862.09 Typical High $2,691.53 | Professional | 56 · Pre-op care only | $1,862.09 | $1,862.09 | $2,691.53 |
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· 31st of 51
$25,704
HI $47,863NJ $22,387
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.