How much rates vary
Facilitymedian $18 · 10th to 90th $17 to $51Professionalmedian $18 · 10th to 90th $13 to $44
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 $11.22 Median $13.18 Typical High $19.05 | Facility | None | $11.22 | $13.18 | $19.05 |
Aetna Setting Professional Modifier None (both parts) Typical Low $13.18 Median $13.18 Typical High $19.05 | Professional | None (both parts) | $13.18 | $13.18 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $31.62 Typical High $61.66 | Facility | None | $30.90 | $31.62 | $61.66 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $15.85 Median $15.85 Typical High $52.48 | Professional | None (both parts) | $15.85 | $15.85 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $1.55 Typical High $3.31 | Professional | RR · Rental | $1.55 | $1.55 | $3.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.48 Median $11.48 Typical High $20.89 | Professional | UE · Used equipment | $11.48 | $11.48 | $20.89 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None (both parts) | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $18.62 | Facility | None | $16.60 | $16.60 | $18.62 |
Cigna Setting Professional Modifier None (both parts) Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None (both parts) | $12.02 | $12.02 | $12.02 |
Emblem Health Setting Facility Modifier None Typical Low $30.90 Median $51.29 Typical High $112.20 | Facility | None | $30.90 | $51.29 | $112.20 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $20.42 Median $33.11 Typical High $54.95 | Professional | None (both parts) | $20.42 | $33.11 | $54.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $18.20 Median $18.20 Typical High $25.70 | Professional | None (both parts) | $18.20 | $18.20 | $25.70 |
MVP Health Care Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $18.20 Median $18.20 Typical High $45.71 | Professional | None (both parts) | $18.20 | $18.20 | $45.71 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $40.74 | Facility | None | $12.88 | $16.22 | $40.74 |
United Setting Professional Modifier None (both parts) Typical Low $10.23 Median $18.62 Typical High $20.89 | Professional | None (both parts) | $10.23 | $18.62 | $20.89 |
Univera Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $19.05 | Facility | None | $18.20 | $18.20 | $19.05 |
Univera Setting Professional Modifier None (both parts) Typical Low $18.20 Median $18.20 Typical High $25.70 | Professional | None (both parts) | $18.20 | $18.20 | $25.70 |
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 $6.61 Median $6.61 Typical High $9.55 | Professional | 52 · Reduced service | $6.61 | $6.61 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $3.89 | Professional | 53 · Discontinued | $2.63 | $2.63 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.88 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.95 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $1.35 Median $2.04 Typical High $2.69 | Professional | 26 · Professional part | $1.35 | $2.04 | $2.69 |
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· 24th of 51
$18.20
HI $36.31DE $12.02
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.