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 $35.48 Median $48.98 Typical High $93.33 | Facility | None | $35.48 | $48.98 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $89.13 | Professional | None | $35.48 | $35.48 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $25.70 | Professional | None | $16.60 | $19.50 | $25.70 |
CDPHP Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Emblem Health Setting Facility Modifier None Typical Low $52.48 Median $79.43 Typical High $190.55 | Facility | None | $52.48 | $79.43 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $100.00 | Professional | None | $54.95 | $63.10 | $100.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $75.86 | Professional | None | $42.66 | $70.79 | $75.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $54.95 | Professional | None | $42.66 | $44.67 | $54.95 |
MVP Health Care Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $75.86 | Professional | None | $10.00 | $10.00 | $75.86 |
United Setting Professional Modifier None Typical Low $16.98 Median $31.62 Typical High $39.81 | Professional | None | $16.98 | $31.62 | $39.81 |
Univera Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Facility | None | $70.79 | $70.79 | $75.86 |
Univera Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $75.86 | Professional | None | $38.02 | $70.79 | $75.86 |
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 $17.78 Median $17.78 Typical High $24.55 | Professional | 52 · Reduced service | $17.78 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $9.77 | Professional | 53 · Discontinued | $7.08 | $7.08 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | 54 · Surgery only | $26.92 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $7.24 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $4.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.47 Typical High $5.25 | Professional | RR · Rental | $4.27 | $4.47 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $32.36 Median $38.02 Typical High $39.81 | Professional | UE · Used equipment | $32.36 | $38.02 | $39.81 |
Where New York sits
The same service costs 2.6 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
$20.89
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.