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 $190.55 Median $229.09 Typical High $331.13 | Facility | None | $190.55 | $229.09 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $331.13 | Professional | None | $229.09 | $229.09 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $501.19 | Professional | None | $169.82 | $199.53 | $501.19 |
CDPHP Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $446.68 | Facility | None | $416.87 | $416.87 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Emblem Health Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,949.84 | Facility | None | $537.03 | $891.25 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $954.99 | Professional | None | $346.74 | $562.34 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $436.52 | Professional | None | $302.00 | $331.13 | $436.52 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $776.25 | Professional | None | $245.47 | $245.47 | $776.25 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $363.08 | Professional | None | $173.78 | $323.59 | $363.08 |
Univera Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $331.13 | Facility | None | $302.00 | $316.23 | $331.13 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $436.52 | Professional | None | $181.97 | $331.13 | $436.52 |
6 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 $114.82 Median $114.82 Typical High $165.96 | Professional | 52 · Reduced service | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $66.07 | Professional | 53 · Discontinued | $45.71 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $50.12 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $33.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | RR · Rental | $28.18 | $28.18 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | UE · Used equipment | $213.80 | $213.80 | $281.84 |
Where New York sits
The same service costs 2.5 times more in Montana than in New York. 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· 51st of 51
$219
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.