How much rates vary
Facilitymedian $3,090 · 10th to 90th $182 to $7,413Professionalmedian $3,162 · 10th to 90th $1,698 to $6,761
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 $1,584.89 Median $1,862.09 Typical High $2,691.53 | Facility | None | $1,584.89 | $1,862.09 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,862.09 | $1,862.09 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $4,466.84 Typical High $8,709.64 | Facility | None | $4,365.16 | $4,466.84 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $8,317.64 | Professional | None | $3,162.28 | $3,162.28 | $8,317.64 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $588.84 | Professional | RR · Rental | $269.15 | $269.15 | $588.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $3,630.78 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $3,630.78 |
CDPHP Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,388.44 | Facility | None | $3,090.30 | $3,090.30 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Emblem Health Setting Facility Modifier None Typical Low $4,365.16 Median $7,244.36 Typical High $15,848.93 | Facility | None | $4,365.16 | $7,244.36 | $15,848.93 |
Emblem Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,365.16 Typical High $7,762.47 | Professional | None | $2,884.03 | $4,365.16 | $7,762.47 |
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 $3,311.31 Typical High $3,630.78 | Professional | None | $181.97 | $3,311.31 | $3,630.78 |
MVP Health Care Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $6,456.54 | Professional | None | $2,691.53 | $2,691.53 | $6,456.54 |
United Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $6,918.31 | Facility | None | $5,370.32 | $5,370.32 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $3,019.95 | Professional | None | $1,445.44 | $2,630.27 | $3,019.95 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $3,311.31 | Facility | None | $181.97 | $181.97 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $3,311.31 Typical High $3,630.78 | Professional | None | $181.97 | $3,311.31 | $3,630.78 |
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 $933.25 Median $933.25 Typical High $1,348.96 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $549.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $407.38 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $269.15 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $269.15 |
Where New York sits
The same service costs 2.0 times more in Montana 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· 20th of 51
$3,162
MT $4,571NJ $2,239
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.