How much rates vary
Facilitymedian $525 · 10th to 90th $295 to $1,023Professionalmedian $269 · 10th to 90th $219 to $389
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 $128.82 Median $229.09 Typical High $269.15 | Facility | None | $128.82 | $229.09 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $912.01 | Facility | None | $457.09 | $457.09 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $660.69 | Professional | None | $363.08 | $363.08 | $660.69 |
CDPHP Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Emblem Health Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,621.81 | Facility | None | $457.09 | $741.31 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $660.69 | Professional | None | $478.63 | $501.19 | $660.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $389.05 | Professional | None | $257.04 | $281.84 | $389.05 |
MVP Health Care Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
MVP Health Care Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $588.84 | Professional | None | $263.03 | $263.03 | $588.84 |
United Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $794.33 | Facility | None | $602.56 | $602.56 | $794.33 |
United Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $295.12 | Professional | None | $169.82 | $239.88 | $295.12 |
Univera Setting Facility Modifier None Typical Low $275.42 Median $457.09 Typical High $457.09 | Facility | None | $275.42 | $457.09 | $457.09 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $457.09 | Professional | None | $199.53 | $281.84 | $457.09 |
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 $114.82 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $45.71 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $26.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | RR · Rental | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | UE · Used equipment | $275.42 | $275.42 | $275.42 |
Where New York sits
The same service costs 2.8 times more in Montana than in Florida. 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· 40th of 51
$269
MT $603FL $219
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.