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 $102.33 Median $138.04 Typical High $162.18 | Facility | None | $102.33 | $138.04 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $74.13 | Professional | None | $46.77 | $56.23 | $74.13 |
CDPHP Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $223.87 Typical High $537.03 | Facility | None | $151.36 | $223.87 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $281.84 | Professional | None | $158.49 | $181.97 | $281.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | None | $123.03 | $123.03 | $131.83 |
MVP Health Care Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $218.78 | Professional | None | $25.70 | $25.70 | $218.78 |
United Setting Professional Modifier None Typical Low $48.98 Median $91.20 Typical High $109.65 | Professional | None | $48.98 | $91.20 | $109.65 |
Univera Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $125.89 | Facility | None | $123.03 | $125.89 | $125.89 |
Univera Setting Professional Modifier None Typical Low $67.61 Median $123.03 Typical High $131.83 | Professional | None | $67.61 | $123.03 | $131.83 |
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 $51.29 Median $51.29 Typical High $69.18 | Professional | 52 · Reduced service | $51.29 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $104.71 | Professional | 54 · Surgery only | $77.62 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $13.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.88 Typical High $15.14 | Professional | RR · Rental | $12.30 | $12.88 | $15.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | UE · Used equipment | $91.20 | $107.15 | $112.20 |
Where New York sits
The same service costs 2.8 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
$58.88
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.