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 $17.38 Median $19.50 Typical High $20.42 | Facility | None | $17.38 | $19.50 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | None | $19.50 | $19.50 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $51.29 | Professional | None | $23.99 | $23.99 | $51.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.40 Median $2.40 Typical High $5.25 | Professional | RR · Rental | $2.40 | $2.40 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17.78 Median $17.78 Typical High $32.36 | Professional | UE · Used equipment | $17.78 | $17.78 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $30.90 | Facility | None | $28.84 | $28.84 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $34.67 | Professional | None | $20.42 | $25.12 | $34.67 |
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 $25.12 Median $25.70 Typical High $27.54 | Professional | None | $25.12 | $25.70 | $27.54 |
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 $26.30 Median $26.30 Typical High $45.71 | Professional | None | $26.30 | $26.30 | $45.71 |
United Setting Professional Modifier None Typical Low $14.79 Median $21.88 Typical High $33.88 | Professional | None | $14.79 | $21.88 | $33.88 |
Univera Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.70 | Facility | None | $25.12 | $25.12 | $25.70 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $27.54 | Professional | None | $25.12 | $25.12 | $27.54 |
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 $9.77 Median $9.77 Typical High $10.00 | Professional | 52 · Reduced service | $9.77 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $4.07 | Professional | 53 · Discontinued | $3.89 | $3.89 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $3.02 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.04 |
Where New York sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 23rd of 51
$23.99
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.