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 $22.91 Median $31.62 Typical High $42.66 | Facility | None | $22.91 | $31.62 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $31.62 | Professional | None | $22.91 | $22.91 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $12.59 Typical High $16.60 | Professional | None | $10.47 | $12.59 | $16.60 |
CDPHP Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Emblem Health Setting Facility Modifier None Typical Low $33.88 Median $51.29 Typical High $123.03 | Facility | None | $33.88 | $51.29 | $123.03 |
Emblem Health Setting Professional Modifier None Typical Low $35.48 Median $40.74 Typical High $64.57 | Professional | None | $35.48 | $40.74 | $64.57 |
Excellus BCBS Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $33.88 | Professional | None | $27.54 | $31.62 | $33.88 |
MVP Health Care Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $48.98 | Professional | None | $8.91 | $8.91 | $48.98 |
United Setting Professional Modifier None Typical Low $10.96 Median $20.42 Typical High $24.55 | Professional | None | $10.96 | $20.42 | $24.55 |
Univera Setting Facility Modifier None Typical Low $31.62 Median $32.36 Typical High $34.67 | Facility | None | $31.62 | $32.36 | $34.67 |
Univera Setting Professional Modifier None Typical Low $17.38 Median $31.62 Typical High $33.88 | Professional | None | $17.38 | $31.62 | $33.88 |
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 $11.48 Median $11.48 Typical High $15.85 | Professional | 52 · Reduced service | $11.48 | $11.48 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $6.31 | Professional | 53 · Discontinued | $4.57 | $4.57 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | 54 · Surgery only | $17.38 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $4.68 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $3.16 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.88 Typical High $3.39 | Professional | RR · Rental | $2.75 | $2.88 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $24.55 Typical High $25.12 | Professional | UE · Used equipment | $20.42 | $24.55 | $25.12 |
Where New York sits
The same service costs 2.6 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
$13.49
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.