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 $50.12 Median $56.23 Typical High $57.54 | Facility | None | $50.12 | $56.23 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | None | $56.23 | $56.23 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $83.18 | Professional | None | $38.90 | $38.90 | $83.18 |
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 $58.88 | Professional | UE · Used equipment | $29.51 | $29.51 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $41.69 | Facility | None | $38.02 | $38.02 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Emblem Health Setting Professional Modifier None Typical Low $43.65 Median $72.44 Typical High $72.44 | Professional | None | $43.65 | $72.44 | $72.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | None | $72.44 | $74.13 | $77.62 |
MVP Health Care Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
MVP Health Care Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $95.50 | Professional | None | $42.66 | $63.10 | $95.50 |
Univera Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $74.13 | Facility | None | $72.44 | $72.44 | $74.13 |
Univera Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | None | $72.44 | $72.44 | $77.62 |
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 $28.18 Median $28.18 Typical High $28.84 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.48 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.75 |
Where New York sits
The same service costs 49.0 times more in North Dakota than in Hawaii. 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· 26th of 51
$56.23
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.