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 $16.60 Median $22.39 Typical High $38.02 | Facility | None | $16.60 | $22.39 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $22.39 | Professional | None | $16.60 | $16.60 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.59 Median $8.91 Typical High $11.75 | Professional | None | $7.59 | $8.91 | $11.75 |
CDPHP Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Emblem Health Setting Facility Modifier None Typical Low $23.99 Median $36.31 Typical High $87.10 | Facility | None | $23.99 | $36.31 | $87.10 |
Emblem Health Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $45.71 | Professional | None | $25.12 | $28.84 | $45.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $19.95 Median $28.84 Typical High $30.90 | Professional | None | $19.95 | $28.84 | $30.90 |
MVP Health Care Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $35.48 | Professional | None | $23.99 | $23.99 | $35.48 |
United Setting Professional Modifier None Typical Low $7.94 Median $14.45 Typical High $18.62 | Professional | None | $7.94 | $14.45 | $18.62 |
Univera Setting Facility Modifier None Typical Low $28.84 Median $29.51 Typical High $29.51 | Facility | None | $28.84 | $29.51 | $29.51 |
Univera Setting Professional Modifier None Typical Low $15.85 Median $28.84 Typical High $30.90 | Professional | None | $15.85 | $28.84 | $30.90 |
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 $8.13 Median $8.13 Typical High $11.22 | Professional | 52 · Reduced service | $8.13 | $8.13 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $4.47 | Professional | 53 · Discontinued | $3.31 | $3.31 | $4.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $12.30 Typical High $16.60 | Professional | 54 · Surgery only | $12.30 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $3.39 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.95 Median $2.04 Typical High $2.40 | Professional | RR · Rental | $1.95 | $2.04 | $2.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $15.49 Typical High $18.20 | Professional | UE · Used equipment | $14.79 | $15.49 | $18.20 |
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
$9.55
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.