How much rates vary
Facilitymedian $8 · 10th to 90th $7 to $19Professionalmedian $7 · 10th to 90th $5 to $17
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 $4.07 Median $4.79 Typical High $6.92 | Facility | None | $4.07 | $4.79 | $6.92 |
Aetna Setting Professional Modifier None (both parts) Typical Low $4.79 Median $4.79 Typical High $6.92 | Professional | None (both parts) | $4.79 | $4.79 | $6.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $11.48 Typical High $22.39 | Facility | None | $11.22 | $11.48 | $22.39 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $6.92 Median $6.92 Typical High $19.95 | Professional | None (both parts) | $6.92 | $6.92 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $0.68 Typical High $1.45 | Professional | RR · Rental | $0.68 | $0.68 | $1.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.01 Median $5.01 Typical High $10.00 | Professional | UE · Used equipment | $5.01 | $5.01 | $10.00 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None (both parts) | $9.12 | $9.12 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.94 | Facility | None | $7.08 | $7.08 | $7.94 |
Cigna Setting Professional Modifier None (both parts) Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None (both parts) | $5.25 | $5.25 | $5.25 |
Emblem Health Setting Facility Modifier None Typical Low $11.22 Median $18.62 Typical High $40.74 | Facility | None | $11.22 | $18.62 | $40.74 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $7.41 Median $11.75 Typical High $19.95 | Professional | None (both parts) | $7.41 | $11.75 | $19.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $6.61 Median $8.32 Typical High $9.12 | Professional | None (both parts) | $6.61 | $8.32 | $9.12 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None (both parts) | $8.91 | $8.91 | $8.91 |
MVP Health Care Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $6.61 Median $6.61 Typical High $16.60 | Professional | None (both parts) | $6.61 | $6.61 | $16.60 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $18.20 | Facility | None | $6.31 | $7.94 | $18.20 |
United Setting Professional Modifier None (both parts) Typical Low $3.72 Median $6.76 Typical High $8.51 | Professional | None (both parts) | $3.72 | $6.76 | $8.51 |
Univera Setting Facility Modifier None Typical Low $6.61 Median $8.32 Typical High $8.32 | Facility | None | $6.61 | $8.32 | $8.32 |
Univera Setting Professional Modifier None (both parts) Typical Low $6.61 Median $8.32 Typical High $9.12 | Professional | None (both parts) | $6.61 | $8.32 | $9.12 |
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 $2.40 Median $2.40 Typical High $3.47 | Professional | 52 · Reduced service | $2.40 | $2.40 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $1.38 | Professional | 53 · Discontinued | $0.95 | $0.95 | $1.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $1.05 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $0.71 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $0.46 Median $0.76 Typical High $0.98 | Professional | 26 · Professional part | $0.46 | $0.76 | $0.98 |
Where New York sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 32nd of 51
$6.92
MT $15.49KS $4.37
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.