How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $30.90 Median $41.69 Typical High $48.98 | Facility | None | $30.90 | $41.69 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $21.88 | Professional | None | $14.13 | $16.60 | $21.88 |
CDPHP Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Emblem Health Setting Facility Modifier None Typical Low $44.67 Median $67.61 Typical High $162.18 | Facility | None | $44.67 | $67.61 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $85.11 | Professional | None | $46.77 | $53.70 | $85.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | None | $37.15 | $37.15 | $39.81 |
MVP Health Care Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $66.07 | Professional | None | $17.78 | $17.78 | $66.07 |
United Setting Professional Modifier None Typical Low $14.45 Median $26.92 Typical High $33.11 | Professional | None | $14.45 | $26.92 | $33.11 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $38.02 Typical High $38.02 | Facility | None | $37.15 | $38.02 | $38.02 |
Univera Setting Professional Modifier None Typical Low $20.42 Median $37.15 Typical High $39.81 | Professional | None | $20.42 | $37.15 | $39.81 |
7 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 $15.14 Median $15.14 Typical High $20.89 | Professional | 52 · Reduced service | $15.14 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $8.32 | Professional | 53 · Discontinued | $6.17 | $6.17 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $30.90 | Professional | 54 · Surgery only | $22.91 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $6.17 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $4.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $3.80 Typical High $4.47 | Professional | RR · Rental | $3.63 | $3.80 | $4.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $32.36 Typical High $33.88 | Professional | UE · Used equipment | $27.54 | $32.36 | $33.88 |
Where New York sits
The same service costs 2.7 times more in Hawaii 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
$17.78
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.