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 $18.62 Median $20.89 Typical High $21.38 | Facility | None | $18.62 | $20.89 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | None | $20.89 | $20.89 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $144.54 | Professional | None | $67.61 | $67.61 | $144.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $6.76 Typical High $14.79 | Professional | RR · Rental | $6.76 | $6.76 | $14.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $51.29 Typical High $91.20 | Professional | UE · Used equipment | $51.29 | $51.29 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $54.95 Typical High $54.95 | Facility | None | $50.12 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Emblem Health Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $58.88 | Professional | None | $40.74 | $50.12 | $58.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $26.92 Median $50.12 Typical High $50.12 | Professional | None | $26.92 | $50.12 | $50.12 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $35.48 | Professional | None | $15.85 | $23.44 | $35.48 |
Univera Setting Facility Modifier None Typical Low $26.92 Median $50.12 Typical High $52.48 | Facility | None | $26.92 | $50.12 | $52.48 |
Univera Setting Professional Modifier None Typical Low $26.92 Median $50.12 Typical High $50.12 | Professional | None | $26.92 | $50.12 | $50.12 |
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 $10.23 Median $10.23 Typical High $10.72 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.27 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.24 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.14 |
Where New York sits
The same service costs 8.9 times more in North Dakota 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· 13th of 51
$42.66
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.