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 $58.88 Median $69.18 Typical High $79.43 | Facility | None | $58.88 | $69.18 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | None | $58.88 | $58.88 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $41.69 | Professional | None | $26.92 | $31.62 | $41.69 |
CDPHP Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $128.82 Typical High $309.03 | Facility | None | $85.11 | $128.82 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $162.18 | Professional | None | $89.13 | $102.33 | $162.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $70.79 | Professional | None | $51.29 | $54.95 | $70.79 |
MVP Health Care Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $125.89 | Professional | None | $15.14 | $15.14 | $125.89 |
United Setting Professional Modifier None Typical Low $27.54 Median $51.29 Typical High $60.26 | Professional | None | $27.54 | $51.29 | $60.26 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $52.48 Typical High $56.23 | Facility | None | $51.29 | $52.48 | $56.23 |
Univera Setting Professional Modifier None Typical Low $28.18 Median $54.95 Typical High $70.79 | Professional | None | $28.18 | $54.95 | $70.79 |
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 $28.84 Median $28.84 Typical High $39.81 | Professional | 52 · Reduced service | $28.84 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $15.85 | Professional | 53 · Discontinued | $11.75 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $58.88 | Professional | 54 · Surgery only | $43.65 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $11.75 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $7.24 Typical High $8.51 | Professional | RR · Rental | $6.92 | $7.24 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $61.66 Typical High $64.57 | Professional | UE · Used equipment | $52.48 | $61.66 | $64.57 |
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
$33.11
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.