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 $27.54 Median $32.36 Typical High $46.77 | Facility | None | $27.54 | $32.36 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $46.77 | Professional | None | $32.36 | $32.36 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $77.62 Typical High $151.36 | Facility | None | $75.86 | $77.62 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $131.83 | Professional | None | $42.66 | $42.66 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $9.33 | Professional | RR · Rental | $4.27 | $4.27 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $69.18 | Professional | UE · Used equipment | $31.62 | $31.62 | $69.18 |
CDPHP Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $46.77 | Facility | None | $43.65 | $43.65 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $275.42 | Facility | None | $75.86 | $125.89 | $275.42 |
Emblem Health Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $134.90 | Professional | None | $48.98 | $75.86 | $134.90 |
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 $44.67 Median $50.12 Typical High $61.66 | Professional | None | $44.67 | $50.12 | $61.66 |
MVP Health Care Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
MVP Health Care Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $109.65 | Professional | None | $45.71 | $45.71 | $109.65 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $120.23 | Facility | None | $93.33 | $93.33 | $120.23 |
United Setting Professional Modifier None Typical Low $24.55 Median $45.71 Typical High $52.48 | Professional | None | $24.55 | $45.71 | $52.48 |
Univera Setting Facility Modifier None Typical Low $42.66 Median $50.12 Typical High $50.12 | Facility | None | $42.66 | $50.12 | $50.12 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $61.66 | Professional | None | $44.67 | $50.12 | $61.66 |
2 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 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $7.08 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $4.68 |
Where New York sits
The same service costs 2.2 times more in Montana than in West Virginia. 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· 25th of 51
$45.71
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.