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 $13.49 Median $14.79 Typical High $15.49 | Facility | None | $13.49 | $14.79 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | None | $14.79 | $14.79 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $117.49 | Professional | None | $54.95 | $54.95 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $12.02 | Professional | RR · Rental | $5.50 | $5.50 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $74.13 | Professional | UE · Used equipment | $40.74 | $40.74 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $29.51 | Facility | None | $28.18 | $28.18 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Emblem Health Setting Professional Modifier None Typical Low $9.77 Median $12.02 Typical High $72.44 | Professional | None | $9.77 | $12.02 | $72.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.02 Median $19.50 Typical High $20.89 | Professional | None | $12.02 | $19.50 | $20.89 |
MVP Health Care Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
MVP Health Care Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
United Setting Professional Modifier None Typical Low $11.48 Median $16.60 Typical High $25.70 | Professional | None | $11.48 | $16.60 | $25.70 |
Univera Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $19.50 | Facility | None | $12.02 | $12.02 | $19.50 |
Univera Setting Professional Modifier None Typical Low $12.02 Median $19.50 Typical High $20.89 | Professional | None | $12.02 | $19.50 | $20.89 |
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 $7.41 Median $7.41 Typical High $7.76 | Professional | 52 · Reduced service | $7.41 | $7.41 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.09 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.29 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.51 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.51 | $1.51 | $1.55 |
Where New York sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 34th of 51
$20.42
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.