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 $25.12 Median $34.67 Typical High $58.88 | Facility | None | $25.12 | $34.67 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $35.48 | Professional | None | $25.12 | $25.12 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.75 Median $13.80 Typical High $18.20 | Professional | None | $11.75 | $13.80 | $18.20 |
CDPHP Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Emblem Health Setting Facility Modifier None Typical Low $37.15 Median $56.23 Typical High $134.90 | Facility | None | $37.15 | $56.23 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $38.90 Median $44.67 Typical High $70.79 | Professional | None | $38.90 | $44.67 | $70.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $46.77 | Professional | None | $30.90 | $43.65 | $46.77 |
MVP Health Care Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $54.95 | Professional | None | $10.00 | $10.00 | $54.95 |
United Setting Professional Modifier None Typical Low $12.02 Median $22.39 Typical High $28.84 | Professional | None | $12.02 | $22.39 | $28.84 |
Univera Setting Facility Modifier None Typical Low $43.65 Median $44.67 Typical High $47.86 | Facility | None | $43.65 | $44.67 | $47.86 |
Univera Setting Professional Modifier None Typical Low $23.99 Median $43.65 Typical High $46.77 | Professional | None | $23.99 | $43.65 | $46.77 |
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 $12.59 Median $12.59 Typical High $17.38 | Professional | 52 · Reduced service | $12.59 | $12.59 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $6.92 | Professional | 53 · Discontinued | $5.13 | $5.13 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $19.05 Typical High $25.70 | Professional | 54 · Surgery only | $19.05 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $3.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.02 Median $3.16 Typical High $3.72 | Professional | RR · Rental | $3.02 | $3.16 | $3.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $23.44 Typical High $28.18 | Professional | UE · Used equipment | $22.91 | $23.44 | $28.18 |
Where New York sits
The same service costs 3.1 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
$14.79
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.