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 $13.80 Median $18.62 Typical High $19.95 | Facility | None | $13.80 | $18.62 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | None | $13.80 | $13.80 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $7.59 Typical High $9.77 | Professional | None | $6.31 | $7.59 | $9.77 |
CDPHP Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Emblem Health Setting Facility Modifier None Typical Low $19.95 Median $30.20 Typical High $72.44 | Facility | None | $19.95 | $30.20 | $72.44 |
Emblem Health Setting Professional Modifier None Typical Low $20.89 Median $23.99 Typical High $38.02 | Professional | None | $20.89 | $23.99 | $38.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $15.14 Median $16.22 Typical High $16.60 | Professional | None | $15.14 | $16.22 | $16.60 |
MVP Health Care Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $29.51 | Professional | None | $7.59 | $7.59 | $29.51 |
United Setting Professional Modifier None Typical Low $6.61 Median $12.02 Typical High $14.79 | Professional | None | $6.61 | $12.02 | $14.79 |
Univera Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $16.22 | Facility | None | $15.14 | $15.14 | $16.22 |
Univera Setting Professional Modifier None Typical Low $8.32 Median $16.22 Typical High $16.60 | Professional | None | $8.32 | $16.22 | $16.60 |
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 $6.92 Median $6.92 Typical High $9.33 | Professional | 52 · Reduced service | $6.92 | $6.92 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $3.72 | Professional | 53 · Discontinued | $2.75 | $2.75 | $3.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.23 Median $10.23 Typical High $13.80 | Professional | 54 · Surgery only | $10.23 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.82 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.62 Median $1.70 Typical High $2.00 | Professional | RR · Rental | $1.62 | $1.70 | $2.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.30 Median $12.88 Typical High $15.14 | Professional | UE · Used equipment | $12.30 | $12.88 | $15.14 |
Where New York sits
The same service costs 2.8 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
$7.94
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.