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 $46.77 Median $52.48 Typical High $102.33 | Facility | None | $46.77 | $52.48 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $102.33 | Professional | None | $46.77 | $46.77 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $190.55 | Professional | None | $69.18 | $69.18 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $6.92 Typical High $15.14 | Professional | RR · Rental | $6.92 | $6.92 | $15.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $93.33 | Professional | UE · Used equipment | $51.29 | $51.29 | $93.33 |
CDPHP Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Emblem Health Setting Facility Modifier None Typical Low $109.65 Median $165.96 Typical High $398.11 | Facility | None | $109.65 | $165.96 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $194.98 | Professional | None | $72.44 | $114.82 | $194.98 |
Excellus BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $89.13 | Professional | None | $60.26 | $64.57 | $89.13 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
MVP Health Care Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $162.18 | Professional | None | $67.61 | $67.61 | $162.18 |
United Setting Professional Modifier None Typical Low $36.31 Median $67.61 Typical High $81.28 | Professional | None | $36.31 | $67.61 | $81.28 |
Univera Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $72.44 | Facility | None | $60.26 | $60.26 | $72.44 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $89.13 | Professional | None | $60.26 | $64.57 | $89.13 |
4 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 $23.44 Median $23.44 Typical High $51.29 | Professional | 52 · Reduced service | $23.44 | $23.44 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $20.42 | Professional | 53 · Discontinued | $9.33 | $9.33 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $15.49 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $10.23 |
Where New York sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 32nd of 51
$69.18
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.