How much rates vary
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 $53.70 Median $93.33 Typical High $199.53 | Facility | None | $53.70 | $93.33 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $93.33 | Professional | None | $64.57 | $64.57 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $302.00 | Facility | None | $151.36 | $154.88 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $275.42 | Professional | None | $102.33 | $102.33 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.23 Median $10.23 Typical High $22.39 | Professional | RR · Rental | $10.23 | $10.23 | $22.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $75.86 Typical High $151.36 | Professional | UE · Used equipment | $75.86 | $75.86 | $151.36 |
CDPHP Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $109.65 | Facility | None | $97.72 | $97.72 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $251.19 Typical High $549.54 | Facility | None | $151.36 | $251.19 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $269.15 | Professional | None | $97.72 | $151.36 | $269.15 |
Excellus BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $123.03 | Professional | None | $95.50 | $114.82 | $123.03 |
MVP Health Care Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
MVP Health Care Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $218.78 | Professional | None | $91.20 | $91.20 | $218.78 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $239.88 | Facility | None | $181.97 | $181.97 | $239.88 |
United Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $120.23 | Professional | None | $48.98 | $89.13 | $120.23 |
Univera Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $114.82 | Facility | None | $95.50 | $95.50 | $114.82 |
Univera Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $123.03 | Professional | None | $95.50 | $114.82 | $123.03 |
2 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 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $14.13 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $9.33 |
Where New York sits
The same service costs 4.2 times more in Kansas than in Delaware. 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· 25th of 51
$102
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.