How much rates vary
Facilitymedian $51 · 10th to 90th $34 to $138Professionalmedian $52 · 10th to 90th $35 to $120
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 $29.51 Median $34.67 Typical High $50.12 | Facility | None | $29.51 | $34.67 | $50.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $34.67 Typical High $50.12 | Professional | None (both parts) | $34.67 | $34.67 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $83.18 Typical High $162.18 | Facility | None | $81.28 | $83.18 | $162.18 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $53.70 Median $53.70 Typical High $147.91 | Professional | None (both parts) | $53.70 | $53.70 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $11.22 | Professional | RR · Rental | $5.25 | $5.25 | $11.22 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.90 Median $38.90 Typical High $70.79 | Professional | UE · Used equipment | $38.90 | $38.90 | $70.79 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None (both parts) | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $57.54 | Facility | None | $51.29 | $51.29 | $57.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None (both parts) | $38.02 | $38.02 | $38.02 |
Emblem Health Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $295.12 | Facility | None | $81.28 | $134.90 | $295.12 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $52.48 Median $87.10 Typical High $144.54 | Professional | None (both parts) | $52.48 | $87.10 | $144.54 |
Excellus BCBS Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $33.88 Median $47.86 Typical High $66.07 | Professional | None (both parts) | $33.88 | $47.86 | $66.07 |
MVP Health Care Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $47.86 Median $47.86 Typical High $120.23 | Professional | None (both parts) | $47.86 | $47.86 | $120.23 |
United Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $131.83 | Facility | None | $53.70 | $64.57 | $131.83 |
United Setting Professional Modifier None (both parts) Typical Low $26.30 Median $48.98 Typical High $61.66 | Professional | None (both parts) | $26.30 | $48.98 | $61.66 |
Univera Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $47.86 | Facility | None | $33.88 | $33.88 | $47.86 |
Univera Setting Professional Modifier None (both parts) Typical Low $33.88 Median $47.86 Typical High $66.07 | Professional | None (both parts) | $33.88 | $47.86 | $66.07 |
6 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 $17.38 Median $17.38 Typical High $25.12 | Professional | 52 · Reduced service | $17.38 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $10.00 | Professional | 53 · Discontinued | $6.92 | $6.92 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $7.59 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $5.01 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $3.72 Median $5.37 Typical High $7.08 | Professional | 26 · Professional part | $3.72 | $5.37 | $7.08 |
Highmark BCBS Setting Professional Modifier K3 · Prosthesis level 3 Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | K3 · Prosthesis level 3 | $64.57 | $64.57 | $64.57 |
Where New York sits
The same service costs 4.9 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· 31st of 51
$52.48
HI $186DE $38.02
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.