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 $112.20 Median $162.18 Typical High $575.44 | Facility | None | $112.20 | $162.18 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $162.18 | Professional | None | $112.20 | $112.20 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $245.47 | Professional | None | $85.11 | $100.00 | $245.47 |
CDPHP Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $208.93 | Facility | None | $194.98 | $194.98 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Emblem Health Setting Facility Modifier None Typical Low $263.03 Median $436.52 Typical High $954.99 | Facility | None | $263.03 | $436.52 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $467.74 | Professional | None | $169.82 | $275.42 | $467.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $213.80 | Professional | None | $147.91 | $165.96 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $2,041.74 | Facility | None | $549.54 | $1,348.96 | $2,041.74 |
MVP Health Care Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $389.05 | Professional | None | $181.97 | $181.97 | $389.05 |
United Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $181.97 | Professional | None | $85.11 | $158.49 | $181.97 |
Univera Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $165.96 | Facility | None | $147.91 | $154.88 | $165.96 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $165.96 Typical High $213.80 | Professional | None | $89.13 | $165.96 | $213.80 |
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 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $16.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $14.13 Median $14.13 Typical High $18.62 | Professional | RR · Rental | $14.13 | $14.13 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | UE · Used equipment | $107.15 | $107.15 | $141.25 |
Where New York sits
The same service costs 2.6 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
$107
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.