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 $74.13 Median $83.18 Typical High $85.11 | Facility | None | $74.13 | $83.18 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | None | $83.18 | $83.18 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $338.84 | Professional | None | $158.49 | $158.49 | $338.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $34.67 | Professional | RR · Rental | $15.85 | $15.85 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $213.80 | Professional | UE · Used equipment | $117.49 | $117.49 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $89.13 | Facility | None | $56.23 | $56.23 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Emblem Health Setting Professional Modifier None Typical Low $14.45 Median $18.20 Typical High $288.40 | Professional | None | $14.45 | $18.20 | $288.40 |
Excellus BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $107.15 | Professional | None | $18.20 | $18.20 | $107.15 |
MVP Health Care Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
MVP Health Care Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $141.25 | Professional | None | $63.10 | $93.33 | $141.25 |
Univera Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $107.15 | Facility | None | $18.20 | $18.20 | $107.15 |
Univera Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $107.15 | Professional | None | $18.20 | $18.20 | $107.15 |
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 $41.69 Median $41.69 Typical High $42.66 | Professional | 52 · Reduced service | $41.69 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | 53 · Discontinued | $16.60 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.51 |
Where New York sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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
$97.72
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.