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 $35.48 Median $109.65 Typical High $181.97 | Facility | None | $35.48 | $109.65 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $181.97 | Professional | None | $109.65 | $109.65 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $120.23 | Professional | None | $58.88 | $58.88 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $12.59 | Professional | RR · Rental | $5.75 | $5.75 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $77.62 | Professional | UE · Used equipment | $42.66 | $42.66 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Emblem Health Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $134.90 | Professional | None | $28.18 | $35.48 | $134.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $19.95 Median $35.48 Typical High $35.48 | Professional | None | $19.95 | $35.48 | $35.48 |
Highmark BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $12,302.69 | Professional | None | $64.57 | $112.20 | $12,302.69 |
Univera Setting Facility Modifier None Typical Low $19.95 Median $35.48 Typical High $35.48 | Facility | None | $19.95 | $35.48 | $35.48 |
Univera Setting Professional Modifier None Typical Low $19.95 Median $35.48 Typical High $35.48 | Professional | None | $19.95 | $35.48 | $35.48 |
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 $54.95 Median $54.95 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $54.95 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $21.88 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $27.54 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $18.20 |
Where New York sits
The same service costs 26.3 times more in Rhode Island than in South Carolina. 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· 37th of 51
$58.88
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.