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 $2.95 Median $3.98 Typical High $8.71 | Facility | None | $2.95 | $3.98 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.98 | Professional | None | $2.95 | $2.95 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.35 Median $1.62 Typical High $2.51 | Professional | None | $1.35 | $1.62 | $2.51 |
CDPHP Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Emblem Health Setting Facility Modifier None Typical Low $4.27 Median $6.46 Typical High $15.49 | Facility | None | $4.27 | $6.46 | $15.49 |
Emblem Health Setting Professional Modifier None Typical Low $4.57 Median $5.13 Typical High $8.13 | Professional | None | $4.57 | $5.13 | $8.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.55 Median $6.46 Typical High $6.92 | Professional | None | $3.55 | $6.46 | $6.92 |
MVP Health Care Setting Professional Modifier None Typical Low $5.01 Median $7.59 Typical High $7.59 | Professional | None | $5.01 | $7.59 | $7.59 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.57 Typical High $3.31 | Professional | None | $1.41 | $2.57 | $3.31 |
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 $1.48 Median $1.48 Typical High $2.00 | Professional | 52 · Reduced service | $1.48 | $1.48 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.79 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.19 Median $2.19 Typical High $3.02 | Professional | 54 · Surgery only | $2.19 | $2.19 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.60 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.36 Typical High $0.43 | Professional | RR · Rental | $0.34 | $0.36 | $0.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.63 Median $2.75 Typical High $3.24 | Professional | UE · Used equipment | $2.63 | $2.75 | $3.24 |
Where New York sits
The same service costs 4.0 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
$1.70
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.