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 $51.29 Median $69.18 Typical High $81.28 | Facility | None | $51.29 | $69.18 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | None | $51.29 | $51.29 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.44 Median $28.18 Typical High $37.15 | Professional | None | $23.44 | $28.18 | $37.15 |
CDPHP Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $112.20 Typical High $269.15 | Facility | None | $75.86 | $112.20 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $141.25 | Professional | None | $79.43 | $91.20 | $141.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | None | $61.66 | $61.66 | $66.07 |
MVP Health Care Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $109.65 | Professional | None | $25.70 | $25.70 | $109.65 |
United Setting Professional Modifier None Typical Low $24.55 Median $44.67 Typical High $54.95 | Professional | None | $24.55 | $44.67 | $54.95 |
Univera Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $63.10 | Facility | None | $61.66 | $63.10 | $63.10 |
Univera Setting Professional Modifier None Typical Low $33.88 Median $61.66 Typical High $66.07 | Professional | None | $33.88 | $61.66 | $66.07 |
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 $25.70 Median $25.70 Typical High $34.67 | Professional | 52 · Reduced service | $25.70 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $13.80 | Professional | 53 · Discontinued | $10.23 | $10.23 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $52.48 | Professional | 54 · Surgery only | $38.90 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $10.47 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.46 Typical High $7.59 | Professional | RR · Rental | $6.17 | $6.46 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $53.70 Typical High $56.23 | Professional | UE · Used equipment | $45.71 | $53.70 | $56.23 |
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
$29.51
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.