How much rates vary
Facilitymedian $275 · 10th to 90th $182 to $661Professionalmedian $295 · 10th to 90th $178 to $617
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 $141.25 Median $169.82 Typical High $245.47 | Facility | None | $141.25 | $169.82 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $245.47 | Professional | None | $169.82 | $169.82 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $794.33 | Facility | None | $398.11 | $407.38 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $758.58 | Professional | None | $295.12 | $295.12 | $758.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $27.54 Typical High $60.26 | Professional | RR · Rental | $27.54 | $27.54 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $208.93 Median $208.93 Typical High $371.54 | Professional | UE · Used equipment | $208.93 | $208.93 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $331.13 | Facility | None | $295.12 | $295.12 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Emblem Health Setting Facility Modifier None Typical Low $398.11 Median $660.69 Typical High $1,445.44 | Facility | None | $398.11 | $660.69 | $1,445.44 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $707.95 | Professional | None | $257.04 | $371.54 | $707.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $323.59 | Professional | None | $181.97 | $295.12 | $323.59 |
Fidelis Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
MVP Health Care Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $575.44 | Professional | None | $177.83 | $177.83 | $575.44 |
United Setting Facility Modifier None Typical Low $186.21 Median $251.19 Typical High $616.60 | Facility | None | $186.21 | $251.19 | $616.60 |
United Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $316.23 | Professional | None | $128.82 | $239.88 | $316.23 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $295.12 | Facility | None | $181.97 | $181.97 | $295.12 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $323.59 | Professional | None | $181.97 | $295.12 | $323.59 |
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 $85.11 Median $85.11 Typical High $123.03 | Professional | 52 · Reduced service | $85.11 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $48.98 | Professional | 53 · Discontinued | $33.88 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $36.31 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $24.55 |
Where New York sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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· 24th of 51
$295
HI $513DC $209
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.