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 $11.75 Median $15.85 Typical High $16.22 | Facility | None | $11.75 | $15.85 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $15.85 | Professional | None | $11.75 | $11.75 | $15.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $6.46 Typical High $8.32 | Professional | None | $5.37 | $6.46 | $8.32 |
CDPHP Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Emblem Health Setting Facility Modifier None Typical Low $16.98 Median $25.70 Typical High $61.66 | Facility | None | $16.98 | $25.70 | $61.66 |
Emblem Health Setting Professional Modifier None Typical Low $18.20 Median $20.42 Typical High $32.36 | Professional | None | $18.20 | $20.42 | $32.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $14.13 | Professional | None | $12.30 | $13.18 | $14.13 |
MVP Health Care Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $25.12 | Professional | None | $12.88 | $12.88 | $25.12 |
United Setting Professional Modifier None Typical Low $5.62 Median $10.23 Typical High $12.02 | Professional | None | $5.62 | $10.23 | $12.02 |
Univera Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $13.18 | Facility | None | $12.30 | $12.30 | $13.18 |
Univera Setting Professional Modifier None Typical Low $6.76 Median $13.18 Typical High $14.13 | Professional | None | $6.76 | $13.18 | $14.13 |
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 $5.89 Median $5.89 Typical High $7.94 | Professional | 52 · Reduced service | $5.89 | $5.89 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $3.16 | Professional | 53 · Discontinued | $2.34 | $2.34 | $3.16 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $8.71 Typical High $12.02 | Professional | 54 · Surgery only | $8.71 | $8.71 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $2.40 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.38 Median $1.45 Typical High $1.74 | Professional | RR · Rental | $1.38 | $1.45 | $1.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.47 Median $12.30 Typical High $12.88 | Professional | UE · Used equipment | $10.47 | $12.30 | $12.88 |
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
$6.76
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.