How much rates vary
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 $24.55 Median $31.62 Typical High $48.98 | Facility | None | $24.55 | $31.62 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $48.98 | Professional | None | $24.55 | $24.55 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $95.50 | Professional | None | $26.30 | $26.30 | $95.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.63 Median $2.63 Typical High $4.57 | Professional | RR · Rental | $2.63 | $2.63 | $4.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $19.50 Typical High $28.18 | Professional | UE · Used equipment | $19.50 | $19.50 | $28.18 |
CDPHP Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Emblem Health Setting Facility Modifier None Typical Low $48.98 Median $74.13 Typical High $177.83 | Facility | None | $48.98 | $74.13 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $93.33 | Professional | None | $44.67 | $53.70 | $93.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Excellus BCBS Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $42.66 | Professional | None | $37.15 | $42.66 | $42.66 |
MVP Health Care Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $70.79 | Professional | None | $33.11 | $33.11 | $70.79 |
United Setting Professional Modifier None Typical Low $16.98 Median $32.36 Typical High $41.69 | Professional | None | $16.98 | $32.36 | $41.69 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $42.66 Typical High $46.77 | Facility | None | $38.02 | $42.66 | $46.77 |
Univera Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $42.66 | Professional | None | $37.15 | $42.66 | $42.66 |
2 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 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $7.41 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $4.90 |
Where New York sits
The same service costs 5.5 times more in Wyoming 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· 27th of 51
$33.11
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.