How much rates vary
Facilitymedian $19 · 10th to 90th $17 to $52Professionalmedian $20 · 10th to 90th $13 to $47
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 $11.48 Median $13.49 Typical High $19.50 | Facility | None | $11.48 | $13.49 | $19.50 |
Aetna Setting Professional Modifier None (both parts) Typical Low $13.49 Median $13.49 Typical High $19.50 | Professional | None (both parts) | $13.49 | $13.49 | $19.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $32.36 Typical High $63.10 | Facility | None | $31.62 | $32.36 | $63.10 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $20.42 Median $20.42 Typical High $57.54 | Professional | None (both parts) | $20.42 | $20.42 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.00 Median $2.00 Typical High $4.27 | Professional | RR · Rental | $2.00 | $2.00 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $14.79 Typical High $26.30 | Professional | UE · Used equipment | $14.79 | $14.79 | $26.30 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None (both parts) | $26.30 | $26.30 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $20.42 | Facility | None | $18.62 | $18.62 | $20.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None (both parts) | $13.49 | $13.49 | $13.49 |
Emblem Health Setting Facility Modifier None Typical Low $31.62 Median $52.48 Typical High $114.82 | Facility | None | $31.62 | $52.48 | $114.82 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $20.89 Median $31.62 Typical High $56.23 | Professional | None (both parts) | $20.89 | $31.62 | $56.23 |
Excellus BCBS Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $16.98 Median $18.62 Typical High $26.30 | Professional | None (both parts) | $16.98 | $18.62 | $26.30 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None (both parts) | $25.12 | $25.12 | $25.12 |
MVP Health Care Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $18.62 Median $18.62 Typical High $46.77 | Professional | None (both parts) | $18.62 | $18.62 | $46.77 |
United Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $43.65 | Facility | None | $14.45 | $16.60 | $43.65 |
United Setting Professional Modifier None (both parts) Typical Low $10.47 Median $19.05 Typical High $21.38 | Professional | None (both parts) | $10.47 | $19.05 | $21.38 |
Univera Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $19.50 | Facility | None | $16.98 | $16.98 | $19.50 |
Univera Setting Professional Modifier None (both parts) Typical Low $16.98 Median $18.62 Typical High $26.30 | Professional | None (both parts) | $16.98 | $18.62 | $26.30 |
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 $6.76 Median $6.76 Typical High $9.77 | Professional | 52 · Reduced service | $6.76 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $3.98 | Professional | 53 · Discontinued | $2.69 | $2.69 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.95 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.35 | $1.35 | $1.95 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $1.38 Median $1.91 Typical High $2.75 | Professional | 26 · Professional part | $1.38 | $1.91 | $2.75 |
Where New York sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 28th of 51
$19.95
HI $37.15PA $13.49
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.