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 $954.99 Median $1,122.02 Typical High $1,659.59 | Facility | None | $954.99 | $1,122.02 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,122.02 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $3,090.30 | Professional | None | $851.14 | $1,000.00 | $3,090.30 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,584.89 | Facility | None | $1,479.11 | $1,479.11 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $2,630.27 Median $4,365.16 Typical High $9,549.93 | Facility | None | $2,630.27 | $4,365.16 | $9,549.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $4,677.35 | Professional | None | $1,737.80 | $2,818.38 | $4,677.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,659.59 | $2,187.76 |
MVP Health Care Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,890.45 | Professional | None | $1,621.81 | $1,621.81 | $3,890.45 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,584.89 Typical High $1,819.70 | Professional | None | $870.96 | $1,584.89 | $1,819.70 |
Univera Setting Facility Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $1,737.80 | Facility | None | $1,479.11 | $1,548.82 | $1,737.80 |
Univera Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,187.76 | Professional | None | $891.25 | $1,659.59 | $2,187.76 |
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 $562.34 Median $562.34 Typical High $812.83 | Professional | 52 · Reduced service | $562.34 | $562.34 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $331.13 | Professional | 53 · Discontinued | $229.09 | $229.09 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $245.47 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $165.96 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $165.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | RR · Rental | $141.25 | $141.25 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,071.52 Median $1,071.52 Typical High $1,412.54 | Professional | UE · Used equipment | $1,071.52 | $1,071.52 | $1,412.54 |
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
$1,072
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.