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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $199.53 | Professional | None | $95.50 | $95.50 | $199.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $9.55 Typical High $19.50 | Professional | RR · Rental | $9.55 | $9.55 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $70.79 Typical High $123.03 | Professional | UE · Used equipment | $70.79 | $70.79 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $154.88 | Facility | None | $102.33 | $102.33 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $34.67 Median $60.26 Typical High $64.57 | Professional | None | $34.67 | $60.26 | $64.57 |
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 $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Where New York sits
The same service costs 11.5 times more in Vermont than in Minnesota. 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· 11th of 51
$100
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.