How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $33.11 Median $44.67 Typical High $77.62 | Facility | None | $33.11 | $44.67 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None | $33.11 | $33.11 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $17.78 Typical High $23.44 | Professional | None | $15.14 | $17.78 | $23.44 |
CDPHP Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Emblem Health Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $173.78 | Facility | None | $47.86 | $72.44 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $91.20 | Professional | None | $50.12 | $57.54 | $91.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $63.10 | Professional | None | $39.81 | $58.88 | $63.10 |
MVP Health Care Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $70.79 | Professional | None | $23.99 | $23.99 | $70.79 |
United Setting Professional Modifier None Typical Low $15.85 Median $28.84 Typical High $37.15 | Professional | None | $15.85 | $28.84 | $37.15 |
Univera Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Univera Setting Professional Modifier None Typical Low $31.62 Median $58.88 Typical High $63.10 | Professional | None | $31.62 | $58.88 | $63.10 |
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 $16.60 Median $16.60 Typical High $22.39 | Professional | 52 · Reduced service | $16.60 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $8.91 | Professional | 53 · Discontinued | $6.61 | $6.61 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | 54 · Surgery only | $24.55 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $6.76 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $4.07 Typical High $4.79 | Professional | RR · Rental | $3.89 | $4.07 | $4.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $34.67 Typical High $36.31 | Professional | UE · Used equipment | $29.51 | $34.67 | $36.31 |
Where New York sits
The same service costs 3.2 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
$19.05
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.