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 $154.88 Median $181.97 Typical High $263.03 | Facility | None | $154.88 | $181.97 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $263.03 | Professional | None | $181.97 | $181.97 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $501.19 | Professional | None | $138.04 | $162.18 | $501.19 |
CDPHP Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $398.11 | Facility | None | $371.54 | $371.54 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Emblem Health Setting Facility Modifier None Typical Low $426.58 Median $707.95 Typical High $1,548.82 | Facility | None | $426.58 | $707.95 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $758.58 | Professional | None | $275.42 | $467.74 | $758.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $346.74 | Professional | None | $239.88 | $269.15 | $346.74 |
MVP Health Care Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $630.96 | Professional | None | $257.04 | $257.04 | $630.96 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $323.59 | Professional | None | $141.25 | $257.04 | $323.59 |
Univera Setting Facility Modifier None Typical Low $239.88 Median $251.19 Typical High $263.03 | Facility | None | $239.88 | $251.19 | $263.03 |
Univera Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $346.74 | Professional | None | $144.54 | $269.15 | $346.74 |
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 $91.20 Median $91.20 Typical High $131.83 | Professional | 52 · Reduced service | $91.20 | $91.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $52.48 | Professional | 53 · Discontinued | $36.31 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $39.81 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $26.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $33.11 | Professional | RR · Rental | $25.12 | $25.12 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $190.55 Typical High $251.19 | Professional | UE · Used equipment | $190.55 | $190.55 | $251.19 |
Where New York sits
The same service costs 3.4 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
$174
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.