How much rates vary
Facilitymedian $66 · 10th to 90th $49 to $191Professionalmedian $69 · 10th to 90th $49 to $162
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 $40.74 Median $47.86 Typical High $70.79 | Facility | None | $40.74 | $47.86 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $70.79 | Professional | None | $47.86 | $47.86 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $114.82 Typical High $229.09 | Facility | None | $112.20 | $114.82 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $194.98 | Professional | None | $61.66 | $61.66 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $13.18 | Professional | RR · Rental | $6.17 | $6.17 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $81.28 | Professional | UE · Used equipment | $45.71 | $45.71 | $81.28 |
CDPHP Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Facility | None | $91.20 | $91.20 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Emblem Health Setting Facility Modifier None Typical Low $112.20 Median $186.21 Typical High $407.38 | Facility | None | $112.20 | $186.21 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $199.53 | Professional | None | $74.13 | $112.20 | $199.53 |
Excellus BCBS Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $93.33 | Professional | None | $48.98 | $66.07 | $93.33 |
MVP Health Care Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
MVP Health Care Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $165.96 | Professional | None | $69.18 | $69.18 | $165.96 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $177.83 | Facility | None | $138.04 | $138.04 | $177.83 |
United Setting Professional Modifier None Typical Low $37.15 Median $67.61 Typical High $77.62 | Professional | None | $37.15 | $67.61 | $77.62 |
Univera Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Facility | None | $48.98 | $48.98 | $66.07 |
Univera Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $93.33 | Professional | None | $48.98 | $66.07 | $93.33 |
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 $23.99 Median $23.99 Typical High $34.67 | Professional | 52 · Reduced service | $23.99 | $23.99 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $14.13 | Professional | 53 · Discontinued | $9.77 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $10.47 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $7.08 |
Where New York sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 41st of 51
$69.18
MT $120VA $61.66
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.