How much rates vary
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 $5.25 Median $7.59 Typical High $11.75 | Facility | None | $5.25 | $7.59 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $11.48 | Professional | None | $7.59 | $7.59 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $501.19 | Professional | None | $380.19 | $436.52 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
MVP Health Care Setting Professional Modifier None Typical Low $11.75 Median $13.80 Typical High $24.55 | Professional | None | $11.75 | $13.80 | $24.55 |
United Setting Professional Modifier None Typical Low $5.13 Median $8.51 Typical High $10.72 | Professional | None | $5.13 | $8.51 | $10.72 |
Univera Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Univera Setting Professional Modifier None Typical Low $5.75 Median $9.77 Typical High $9.77 | Professional | None | $5.75 | $9.77 | $9.77 |
3 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 $1.12 Median $1.12 Typical High $1.74 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $1.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $100.00 Typical High $208.93 | Professional | RR · Rental | $25.12 | $100.00 | $208.93 |
Where New York sits
The same service costs 95.5 times more in New York than in Kentucky. 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· 1st of 51
$398
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.