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 $10.47 Median $14.45 Typical High $37.15 | Facility | None | $10.47 | $14.45 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $5.75 Typical High $8.91 | Professional | None | $4.79 | $5.75 | $8.91 |
CDPHP Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Emblem Health Setting Facility Modifier None Typical Low $15.49 Median $23.44 Typical High $56.23 | Facility | None | $15.49 | $23.44 | $56.23 |
Emblem Health Setting Professional Modifier None Typical Low $16.22 Median $18.62 Typical High $29.51 | Professional | None | $16.22 | $18.62 | $29.51 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.59 Median $28.18 Typical High $30.20 | Professional | None | $12.59 | $28.18 | $30.20 |
Highmark BCBS Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | None | $12.59 | $12.59 | $13.18 |
MVP Health Care Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $22.91 | Professional | None | $8.91 | $8.91 | $22.91 |
United Setting Professional Modifier None Typical Low $5.01 Median $9.33 Typical High $12.02 | Professional | None | $5.01 | $9.33 | $12.02 |
Univera Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $30.20 | Facility | None | $28.18 | $28.18 | $30.20 |
Univera Setting Professional Modifier None Typical Low $12.59 Median $28.18 Typical High $30.20 | Professional | None | $12.59 | $28.18 | $30.20 |
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 $5.25 Median $5.25 Typical High $7.24 | Professional | 52 · Reduced service | $5.25 | $5.25 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $2.88 | Professional | 53 · Discontinued | $2.14 | $2.14 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $7.94 Typical High $10.72 | Professional | 54 · Surgery only | $7.94 | $7.94 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $2.14 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $1.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.26 Median $1.32 Typical High $1.55 | Professional | RR · Rental | $1.26 | $1.32 | $1.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.55 Median $11.22 Typical High $11.75 | Professional | UE · Used equipment | $9.55 | $11.22 | $11.75 |
Where New York sits
The same service costs 4.5 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
$6.17
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.