How much rates vary
Facilitymedian $19 · 10th to 90th $14 to $44Professionalmedian $15 · 10th to 90th $11 to $37
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 $9.33 Median $15.85 Typical High $29.51 | Facility | None | $9.33 | $15.85 | $29.51 |
Aetna Setting Professional Modifier None (both parts) Typical Low $10.96 Median $10.96 Typical High $15.85 | Professional | None (both parts) | $10.96 | $10.96 | $15.85 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None (both parts) | $17.38 | $17.38 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $26.30 Typical High $51.29 | Facility | None | $25.70 | $26.30 | $51.29 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $14.13 Median $14.13 Typical High $44.67 | Professional | None (both parts) | $14.13 | $14.13 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $1.35 Typical High $2.95 | Professional | RR · Rental | $1.35 | $1.35 | $2.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $10.23 Typical High $18.20 | Professional | UE · Used equipment | $10.23 | $10.23 | $18.20 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None (both parts) | $20.89 | $20.89 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $15.85 | Facility | None | $14.45 | $14.45 | $15.85 |
Cigna Setting Professional Modifier None (both parts) Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None (both parts) | $10.47 | $10.47 | $10.47 |
Emblem Health Setting Facility Modifier None Typical Low $25.70 Median $42.66 Typical High $93.33 | Facility | None | $25.70 | $42.66 | $93.33 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $16.60 Median $26.92 Typical High $45.71 | Professional | None (both parts) | $16.60 | $26.92 | $45.71 |
Excellus BCBS Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $15.14 Median $19.05 Typical High $20.89 | Professional | None (both parts) | $15.14 | $19.05 | $20.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None (both parts) | $20.42 | $20.42 | $20.42 |
MVP Health Care Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $15.14 Median $15.14 Typical High $37.15 | Professional | None (both parts) | $15.14 | $15.14 | $37.15 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $30.90 | Facility | None | $12.59 | $12.88 | $30.90 |
United Setting Professional Modifier None (both parts) Typical Low $8.32 Median $14.13 Typical High $16.98 | Professional | None (both parts) | $8.32 | $14.13 | $16.98 |
Univera Setting Facility Modifier None Typical Low $15.14 Median $19.05 Typical High $19.05 | Facility | None | $15.14 | $19.05 | $19.05 |
Univera Setting Professional Modifier None (both parts) Typical Low $15.14 Median $19.05 Typical High $20.89 | Professional | None (both parts) | $15.14 | $19.05 | $20.89 |
5 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 $5.50 Median $5.50 Typical High $7.94 | Professional | 52 · Reduced service | $5.50 | $5.50 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $3.16 | Professional | 53 · Discontinued | $2.19 | $2.19 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.62 Typical High $2.40 | Professional | 55 · Aftercare only | $1.62 | $1.62 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.58 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $1.02 Median $2.00 Typical High $2.24 | Professional | 26 · Professional part | $1.02 | $2.00 | $2.24 |
Where New York sits
The same service costs 3.0 times more in Hawaii 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· 19th of 51
$15.14
HI $31.62DE $10.47
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.