How much rates vary
Facilitymedian $25 · 10th to 90th $19 to $54Professionalmedian $25 · 10th to 90th $15 to $45
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 $11.22 Median $13.49 Typical High $19.50 | Facility | None | $11.22 | $13.49 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $19.50 | Professional | None | $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 Typical Low $25.12 Median $25.70 Typical High $54.95 | Professional | None | $25.12 | $25.70 | $54.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $4.79 | Professional | RR · Rental | $2.51 | $2.51 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.62 Median $18.62 Typical High $33.88 | Professional | UE · Used equipment | $18.62 | $18.62 | $33.88 |
CDPHP Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $26.92 | Facility | None | $25.12 | $25.12 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
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 Typical Low $20.42 Median $33.11 Typical High $56.23 | Professional | None | $20.42 | $33.11 | $56.23 |
Excellus BCBS Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $25.70 | Professional | None | $17.78 | $19.95 | $25.70 |
MVP Health Care Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
MVP Health Care Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $45.71 | Professional | None | $19.05 | $19.05 | $45.71 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $50.12 | Facility | None | $38.90 | $38.90 | $50.12 |
United Setting Professional Modifier None Typical Low $10.23 Median $19.05 Typical High $21.88 | Professional | None | $10.23 | $19.05 | $21.88 |
Univera Setting Facility Modifier None Typical Low $18.62 Median $23.44 Typical High $23.44 | Facility | None | $18.62 | $23.44 | $23.44 |
Univera Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $25.70 | Professional | None | $17.78 | $19.95 | $25.70 |
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 $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 $3.89 | Professional | 53 · Discontinued | $2.69 | $2.69 | $3.89 |
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 |
Where New York sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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· 19th of 51
$25.12
MN $37.15DC $17.38
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.