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 $3.72 Median $5.13 Typical High $10.47 | Facility | None | $3.72 | $5.13 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $5.13 | Professional | None | $3.72 | $3.72 | $5.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $2.04 Typical High $2.82 | Professional | None | $1.74 | $2.04 | $2.82 |
CDPHP Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Emblem Health Setting Facility Modifier None Typical Low $5.50 Median $8.32 Typical High $19.95 | Facility | None | $5.50 | $8.32 | $19.95 |
Emblem Health Setting Professional Modifier None Typical Low $5.75 Median $6.61 Typical High $10.47 | Professional | None | $5.75 | $6.61 | $10.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.47 Median $7.76 Typical High $8.32 | Professional | None | $4.47 | $7.76 | $8.32 |
MVP Health Care Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $7.94 | Professional | None | $6.46 | $7.59 | $7.94 |
United Setting Professional Modifier None Typical Low $1.78 Median $3.31 Typical High $4.37 | Professional | None | $1.78 | $3.31 | $4.37 |
Univera Setting Facility Modifier None Typical Low $7.76 Median $7.94 Typical High $8.71 | Facility | None | $7.76 | $7.94 | $8.71 |
Univera Setting Professional Modifier None Typical Low $4.37 Median $7.76 Typical High $8.32 | Professional | None | $4.37 | $7.76 | $8.32 |
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 $1.86 Median $1.86 Typical High $2.51 | Professional | 52 · Reduced service | $1.86 | $1.86 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $1.02 | Professional | 53 · Discontinued | $0.76 | $0.76 | $1.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.82 Median $2.82 Typical High $3.80 | Professional | 54 · Surgery only | $2.82 | $2.82 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.78 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $0.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.45 Median $0.46 Typical High $0.55 | Professional | RR · Rental | $0.45 | $0.46 | $0.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.39 Median $3.55 Typical High $4.17 | Professional | UE · Used equipment | $3.39 | $3.55 | $4.17 |
Where New York sits
The same service costs 3.8 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
$2.19
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.