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 $31.62 Median $69.18 Typical High $91.20 | Facility | None | $31.62 | $69.18 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $91.20 | Professional | None | $69.18 | $69.18 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $169.82 | Facility | None | $85.11 | $85.11 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $120.23 | Professional | None | $53.70 | $53.70 | $120.23 |
CDPHP Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $69.18 | Facility | None | $64.57 | $64.57 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $85.11 Typical High $190.55 | Facility | None | $39.81 | $85.11 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $147.91 | Professional | None | $77.62 | $93.33 | $147.91 |
Excellus BCBS Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $79.43 | Professional | None | $50.12 | $53.70 | $79.43 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $79.43 | Professional | None | $46.77 | $46.77 | $79.43 |
United Setting Professional Modifier None Typical Low $30.20 Median $56.23 Typical High $75.86 | Professional | None | $30.20 | $56.23 | $75.86 |
Univera Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Univera Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $79.43 | Professional | None | $50.12 | $53.70 | $79.43 |
6 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 $34.67 Median $34.67 Typical High $45.71 | Professional | 52 · Reduced service | $34.67 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $18.20 | Professional | 53 · Discontinued | $13.80 | $13.80 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $13.80 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $6.46 Typical High $53.70 | Professional | RR · Rental | $5.37 | $6.46 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $69.18 | Professional | UE · Used equipment | $39.81 | $39.81 | $69.18 |
Where New York sits
The same service costs 2.5 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· 47th of 51
$53.70
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.