How much rates vary
Facilitymedian $51 · 10th to 90th $38 to $148Professionalmedian $52 · 10th to 90th $38 to $126
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 $31.62 Median $37.15 Typical High $53.70 | Facility | None | $31.62 | $37.15 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | None | $37.15 | $37.15 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $89.13 Typical High $173.78 | Facility | None | $87.10 | $89.13 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $151.36 | Professional | None | $48.98 | $48.98 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $10.23 | Professional | RR · Rental | $4.79 | $4.79 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $35.48 Typical High $64.57 | Professional | UE · Used equipment | $35.48 | $35.48 | $64.57 |
CDPHP Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $74.13 | Facility | None | $69.18 | $69.18 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Emblem Health Setting Facility Modifier None Typical Low $87.10 Median $144.54 Typical High $316.23 | Facility | None | $87.10 | $144.54 | $316.23 |
Emblem Health Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $154.88 | Professional | None | $56.23 | $81.28 | $154.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $70.79 | Professional | None | $38.02 | $51.29 | $70.79 |
MVP Health Care Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
MVP Health Care Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $128.82 | Professional | None | $52.48 | $52.48 | $128.82 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $138.04 | Facility | None | $107.15 | $107.15 | $138.04 |
United Setting Professional Modifier None Typical Low $28.18 Median $52.48 Typical High $60.26 | Professional | None | $28.18 | $52.48 | $60.26 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Facility | None | $38.02 | $38.02 | $51.29 |
Univera Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $70.79 | Professional | None | $38.02 | $51.29 | $70.79 |
4 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 $18.62 Median $18.62 Typical High $26.92 | Professional | 52 · Reduced service | $18.62 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $10.72 | Professional | 53 · Discontinued | $7.41 | $7.41 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $5.37 |
Where New York sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 42nd of 51
$52.48
MT $93.33SC $46.77
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.