How much rates vary
Facilitymedian $295 · 10th to 90th $195 to $661Professionalmedian $117 · 10th to 90th $95 to $191
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $83.18 Median $147.91 Typical High $173.78 | Facility | None | $83.18 | $147.91 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | None | $147.91 | $147.91 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $588.84 | Facility | None | $295.12 | $295.12 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $123.03 | Professional | None | $95.50 | $112.20 | $123.03 |
CDPHP Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Emblem Health Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $1,071.52 | Facility | None | $295.12 | $489.78 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $426.58 | Professional | None | $323.59 | $323.59 | $426.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $288.40 | Professional | None | $173.78 | $173.78 | $288.40 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $389.05 | Facility | None | $295.12 | $295.12 | $389.05 |
United Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $190.55 | Professional | None | $100.00 | $154.88 | $190.55 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $295.12 | Facility | None | $181.97 | $295.12 | $295.12 |
Univera Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $251.19 | Professional | None | $165.96 | $165.96 | $251.19 |
8 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 $74.13 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $74.13 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | 53 · Discontinued | $30.20 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $181.97 Typical High $223.87 | Professional | UE · Used equipment | $138.04 | $181.97 | $223.87 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where New York sits
The same service costs 2.8 times more in Minnesota than in Utah. 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· 46th of 51
$117
MN $295UT $107
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.