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 $21.38 Median $23.99 Typical High $24.55 | Facility | None | $21.38 | $23.99 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | None | $23.99 | $23.99 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $107.15 | Professional | None | $50.12 | $50.12 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $10.96 | Professional | RR · Rental | $5.01 | $5.01 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $67.61 | Professional | UE · Used equipment | $38.02 | $38.02 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $32.36 | Facility | None | $30.20 | $30.20 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Emblem Health Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $48.98 | Professional | None | $28.18 | $35.48 | $48.98 |
Excellus BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $35.48 | Professional | None | $30.90 | $33.11 | $35.48 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
MVP Health Care Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $40.74 | Professional | None | $18.20 | $26.92 | $40.74 |
Univera Setting Facility Modifier None Typical Low $30.90 Median $35.48 Typical High $35.48 | Facility | None | $30.90 | $35.48 | $35.48 |
Univera Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $35.48 | Professional | None | $30.90 | $33.11 | $35.48 |
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 $12.02 Median $12.02 Typical High $12.30 | Professional | 52 · Reduced service | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $4.90 | Professional | 53 · Discontinued | $4.79 | $4.79 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $2.45 |
Where New York sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 19th of 51
$35.48
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.