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 $25.12 Median $33.11 Typical High $54.95 | Facility | None | $25.12 | $33.11 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $54.95 | Professional | None | $25.12 | $25.12 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $100.00 | Professional | None | $30.90 | $50.12 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.88 Median $2.88 Typical High $6.61 | Professional | RR · Rental | $2.88 | $2.88 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $21.88 Median $21.88 Typical High $38.90 | Professional | UE · Used equipment | $21.88 | $21.88 | $38.90 |
CDPHP Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $43.65 | Facility | None | $40.74 | $40.74 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Emblem Health Setting Facility Modifier None Typical Low $58.88 Median $89.13 Typical High $213.80 | Facility | None | $58.88 | $89.13 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $102.33 | Professional | None | $38.90 | $54.95 | $102.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $47.86 | Professional | None | $30.20 | $41.69 | $47.86 |
MVP Health Care Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
MVP Health Care Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $87.10 | Professional | None | $35.48 | $35.48 | $87.10 |
United Setting Professional Modifier None Typical Low $19.50 Median $32.36 Typical High $41.69 | Professional | None | $19.50 | $32.36 | $41.69 |
Univera Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $41.69 | Facility | None | $30.20 | $30.20 | $41.69 |
Univera Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $47.86 | Professional | None | $30.20 | $41.69 | $47.86 |
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 $3.80 Median $3.80 Typical High $8.32 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $5.50 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $5.50 |
Where New York sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 36th of 51
$36.31
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.