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 $16.60 Median $18.20 Typical High $19.05 | Facility | None | $16.60 | $18.20 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | None | $18.20 | $18.20 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $85.11 | Professional | None | $38.90 | $38.90 | $85.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $3.89 Typical High $8.51 | Professional | RR · Rental | $3.89 | $3.89 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $52.48 | Professional | UE · Used equipment | $29.51 | $29.51 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $29.51 | Facility | None | $27.54 | $27.54 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $29.51 | Professional | None | $20.42 | $25.12 | $29.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $23.44 Median $25.12 Typical High $25.12 | Professional | None | $23.44 | $25.12 | $25.12 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
MVP Health Care Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $14.13 Median $20.42 Typical High $31.62 | Professional | None | $14.13 | $20.42 | $31.62 |
Univera Setting Facility Modifier None Typical Low $23.44 Median $25.12 Typical High $25.12 | Facility | None | $23.44 | $25.12 | $25.12 |
Univera Setting Professional Modifier None Typical Low $23.44 Median $25.12 Typical High $25.12 | Professional | None | $23.44 | $25.12 | $25.12 |
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 $9.12 Median $9.12 Typical High $9.55 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.88 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.91 |
Where New York sits
The same service costs 4.4 times more in Wyoming 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· 25th of 51
$25.12
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.