How much rates vary
Facilitymedian $6,457 · 10th to 90th $5,623 to $22,387Professionalmedian $4,074 · 10th to 90th $3,236 to $8,913
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 $3,801.89 Median $4,265.80 Typical High $31,622.78 | Facility | None | $3,801.89 | $4,265.80 | $31,622.78 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $6,165.95 | Professional | None | $4,265.80 | $4,265.80 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $11,748.98 | Professional | None | $3,235.94 | $3,801.89 | $11,748.98 |
CDPHP Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,025.60 | Facility | None | $5,623.41 | $5,623.41 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $10,000.00 Median $16,595.87 Typical High $36,307.81 | Facility | None | $10,000.00 | $16,595.87 | $36,307.81 |
Emblem Health Setting Professional Modifier None Typical Low $6,456.54 Median $10,471.29 Typical High $17,782.79 | Professional | None | $6,456.54 | $10,471.29 | $17,782.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $6,165.95 Median $6,918.31 Typical High $8,128.31 | Professional | None | $6,165.95 | $6,918.31 | $8,128.31 |
MVP Health Care Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $14,791.08 | Professional | None | $6,025.60 | $6,025.60 | $14,791.08 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $6,025.60 Typical High $7,079.46 | Professional | None | $3,235.94 | $6,025.60 | $7,079.46 |
Univera Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
Univera Setting Professional Modifier None Typical Low $6,165.95 Median $6,918.31 Typical High $8,128.31 | Professional | None | $6,165.95 | $6,918.31 | $8,128.31 |
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 $2,137.96 Median $2,137.96 Typical High $3,090.30 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $1,230.27 | Professional | 53 · Discontinued | $851.14 | $851.14 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $645.65 Typical High $933.25 | Professional | 55 · Aftercare only | $645.65 | $645.65 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $616.60 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $616.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $489.78 Typical High $724.44 | Professional | RR · Rental | $489.78 | $489.78 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $3,630.78 Typical High $5,370.32 | Professional | UE · Used equipment | $3,630.78 | $3,630.78 | $5,370.32 |
Where New York sits
The same service costs 2.6 times more in Montana than in New York. 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· 51st of 51
$4,169
MT $10,715NY $4,169
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.