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 $11.22 Median $15.14 Typical High $27.54 | Facility | None | $11.22 | $15.14 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $15.14 | Professional | None | $11.22 | $11.22 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $6.17 Typical High $8.51 | Professional | None | $5.13 | $6.17 | $8.51 |
CDPHP Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Emblem Health Setting Facility Modifier None Typical Low $16.60 Median $24.55 Typical High $60.26 | Facility | None | $16.60 | $24.55 | $60.26 |
Emblem Health Setting Professional Modifier None Typical Low $17.38 Median $19.95 Typical High $30.90 | Professional | None | $17.38 | $19.95 | $30.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $13.49 Median $20.89 Typical High $22.39 | Professional | None | $13.49 | $20.89 | $22.39 |
MVP Health Care Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $23.99 | Professional | None | $8.91 | $8.91 | $23.99 |
United Setting Professional Modifier None Typical Low $5.37 Median $10.00 Typical High $12.59 | Professional | None | $5.37 | $10.00 | $12.59 |
Univera Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Univera Setting Professional Modifier None Typical Low $11.22 Median $20.89 Typical High $22.39 | Professional | None | $11.22 | $20.89 | $22.39 |
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 $5.62 Median $5.62 Typical High $7.59 | Professional | 52 · Reduced service | $5.62 | $5.62 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $3.09 | Professional | 53 · Discontinued | $2.24 | $2.24 | $3.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $8.51 Typical High $11.48 | Professional | 54 · Surgery only | $8.51 | $8.51 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $2.29 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $1.41 Typical High $1.66 | Professional | RR · Rental | $1.35 | $1.41 | $1.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $10.47 Typical High $12.30 | Professional | UE · Used equipment | $10.00 | $10.47 | $12.30 |
Where New York sits
The same service costs 3.2 times more in Rhode Island 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
$6.61
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.