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 $3.98 Median $5.37 Typical High $8.71 | Facility | None | $3.98 | $5.37 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $5.37 | Professional | None | $3.98 | $3.98 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $2.19 Typical High $3.31 | Professional | None | $1.82 | $2.19 | $3.31 |
CDPHP Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Emblem Health Setting Facility Modifier None Typical Low $5.75 Median $8.71 Typical High $20.89 | Facility | None | $5.75 | $8.71 | $20.89 |
Emblem Health Setting Professional Modifier None Typical Low $6.03 Median $6.92 Typical High $10.96 | Professional | None | $6.03 | $6.92 | $10.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $6.92 | Professional | None | $4.79 | $6.46 | $6.92 |
MVP Health Care Setting Professional Modifier None Typical Low $6.76 Median $8.91 Typical High $8.91 | Professional | None | $6.76 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $1.91 Median $3.47 Typical High $4.47 | Professional | None | $1.91 | $3.47 | $4.47 |
Univera Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.92 | Facility | None | $6.46 | $6.46 | $6.92 |
Univera Setting Professional Modifier None Typical Low $3.55 Median $6.46 Typical High $6.92 | Professional | None | $3.55 | $6.46 | $6.92 |
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 $2.00 Median $2.00 Typical High $2.69 | Professional | 52 · Reduced service | $2.00 | $2.00 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.79 Typical High $1.07 | Professional | 53 · Discontinued | $0.79 | $0.79 | $1.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.95 Median $2.95 Typical High $4.07 | Professional | 54 · Surgery only | $2.95 | $2.95 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.60 Typical High $0.81 | Professional | 55 · Aftercare only | $0.60 | $0.60 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $0.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.47 Median $0.49 Typical High $0.58 | Professional | RR · Rental | $0.47 | $0.49 | $0.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.55 Median $3.72 Typical High $4.37 | Professional | UE · Used equipment | $3.55 | $3.72 | $4.37 |
Where New York sits
The same service costs 3.0 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
$2.29
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.