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 $1,659.59 Median $1,995.26 Typical High $2,884.03 | Facility | None | $1,659.59 | $1,995.26 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,995.26 | $1,995.26 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $9,332.54 | Facility | None | $4,677.35 | $4,786.30 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $7,943.28 | Professional | None | $2,754.23 | $2,884.03 | $7,943.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $275.42 Median $275.42 Typical High $602.56 | Professional | RR · Rental | $275.42 | $275.42 | $602.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,089.30 Median $2,089.30 Typical High $3,715.35 | Professional | UE · Used equipment | $2,089.30 | $2,089.30 | $3,715.35 |
CDPHP Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,090.30 | Facility | None | $2,884.03 | $2,884.03 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Emblem Health Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $16,982.44 | Facility | None | $4,677.35 | $7,762.47 | $16,982.44 |
Emblem Health Setting Professional Modifier None Typical Low $3,019.95 Median $4,897.79 Typical High $8,317.64 | Professional | None | $3,019.95 | $4,897.79 | $8,317.64 |
Excellus BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,754.23 | $3,801.89 |
MVP Health Care Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
MVP Health Care Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $6,760.83 | Professional | None | $2,691.53 | $2,691.53 | $6,760.83 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,090.30 Typical High $7,413.10 | Facility | None | $3,019.95 | $3,090.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $3,548.13 | Professional | None | $1,513.56 | $2,818.38 | $3,548.13 |
Univera Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,754.23 | Facility | None | $2,187.76 | $2,187.76 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,754.23 | $3,801.89 |
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 $1,000.00 Median $1,000.00 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $575.44 | Professional | 53 · Discontinued | $398.11 | $398.11 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $436.52 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $288.40 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $288.40 |
Where New York sits
The same service costs 3.4 times more in Hawaii 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· 38th of 51
$2,754
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.