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 $28.84 Median $33.88 Typical High $39.81 | Facility | None | $28.84 | $33.88 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $39.81 | Professional | None | $28.84 | $28.84 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $20.89 | Professional | None | $13.49 | $15.85 | $20.89 |
CDPHP Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Emblem Health Setting Facility Modifier None Typical Low $42.66 Median $64.57 Typical High $154.88 | Facility | None | $42.66 | $64.57 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $81.28 | Professional | None | $44.67 | $51.29 | $81.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $35.48 | Professional | None | $26.30 | $28.18 | $35.48 |
MVP Health Care Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $63.10 | Professional | None | $15.14 | $15.14 | $63.10 |
United Setting Professional Modifier None Typical Low $13.80 Median $25.70 Typical High $30.20 | Professional | None | $13.80 | $25.70 | $30.20 |
Univera Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $28.18 | Facility | None | $26.30 | $26.30 | $28.18 |
Univera Setting Professional Modifier None Typical Low $14.13 Median $28.18 Typical High $35.48 | Professional | None | $14.13 | $28.18 | $35.48 |
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 $14.45 Median $14.45 Typical High $19.95 | Professional | 52 · Reduced service | $14.45 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.94 | Professional | 53 · Discontinued | $5.89 | $5.89 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $21.88 Typical High $29.51 | Professional | 54 · Surgery only | $21.88 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $5.89 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.63 Typical High $4.27 | Professional | RR · Rental | $3.47 | $3.63 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $30.90 Typical High $32.36 | Professional | UE · Used equipment | $26.30 | $30.90 | $32.36 |
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
$16.60
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.