How much rates vary
Facilitymedian $8,710 · 10th to 90th $5,888 to $27,542Professionalmedian $8,128 · 10th to 90th $5,888 to $19,953
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 $5,011.87 Median $5,888.44 Typical High $8,511.38 | Facility | None | $5,011.87 | $5,888.44 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $8,511.38 | Professional | None | $5,888.44 | $5,888.44 | $8,511.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $13,803.84 Median $14,125.38 Typical High $27,542.29 | Facility | None | $13,803.84 | $14,125.38 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $23,442.29 | Professional | None | $6,760.83 | $6,760.83 | $23,442.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $676.08 Median $676.08 Typical High $1,479.11 | Professional | RR · Rental | $676.08 | $676.08 | $1,479.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,128.61 Median $5,128.61 Typical High $9,120.11 | Professional | UE · Used equipment | $5,128.61 | $5,128.61 | $9,120.11 |
CDPHP Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Professional | None | $11,220.18 | $11,220.18 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $9,332.54 | Facility | None | $8,709.64 | $8,709.64 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
Emblem Health Setting Facility Modifier None Typical Low $13,803.84 Median $22,908.68 Typical High $50,118.72 | Facility | None | $13,803.84 | $22,908.68 | $50,118.72 |
Emblem Health Setting Professional Modifier None Typical Low $8,912.51 Median $14,454.40 Typical High $24,547.09 | Professional | None | $8,912.51 | $14,454.40 | $24,547.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $7,762.47 Median $8,709.64 Typical High $11,220.18 | Professional | None | $7,762.47 | $8,709.64 | $11,220.18 |
MVP Health Care Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $20,417.38 | Professional | None | $8,128.31 | $8,128.31 | $20,417.38 |
United Setting Facility Modifier None Typical Low $4,466.84 Median $5,495.41 Typical High $18,197.01 | Facility | None | $4,466.84 | $5,495.41 | $18,197.01 |
United Setting Professional Modifier None Typical Low $4,466.84 Median $7,943.28 Typical High $9,120.11 | Professional | None | $4,466.84 | $7,943.28 | $9,120.11 |
Univera Setting Facility Modifier None Typical Low $7,762.47 Median $8,128.31 Typical High $8,511.38 | Facility | None | $7,762.47 | $8,128.31 | $8,511.38 |
Univera Setting Professional Modifier None Typical Low $7,762.47 Median $8,709.64 Typical High $11,220.18 | Professional | None | $7,762.47 | $8,709.64 | $11,220.18 |
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 $2,951.21 Median $2,951.21 Typical High $4,265.80 | Professional | 52 · Reduced service | $2,951.21 | $2,951.21 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,174.90 Typical High $1,698.24 | Professional | 53 · Discontinued | $1,174.90 | $1,174.90 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $891.25 Median $891.25 Typical High $1,288.25 | Professional | 55 · Aftercare only | $891.25 | $891.25 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $588.84 Typical High $851.14 | Professional | 56 · Pre-op care only | $588.84 | $588.84 | $851.14 |
Where New York sits
The same service costs 2.3 times more in Montana than in West Virginia. 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· 23rd of 51
$8,128
MT $14,791WV $6,310
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.