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 $17.38 Median $23.44 Typical High $25.12 | Facility | None | $17.38 | $23.44 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | None | $17.38 | $17.38 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.94 Median $9.55 Typical High $12.59 | Professional | None | $7.94 | $9.55 | $12.59 |
CDPHP Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Emblem Health Setting Facility Modifier None Typical Low $25.70 Median $38.02 Typical High $91.20 | Facility | None | $25.70 | $38.02 | $91.20 |
Emblem Health Setting Professional Modifier None Typical Low $26.92 Median $30.90 Typical High $47.86 | Professional | None | $26.92 | $30.90 | $47.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $18.62 Median $19.95 Typical High $20.89 | Professional | None | $18.62 | $19.95 | $20.89 |
MVP Health Care Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $37.15 | Professional | None | $12.02 | $12.02 | $37.15 |
United Setting Professional Modifier None Typical Low $8.32 Median $15.14 Typical High $18.62 | Professional | None | $8.32 | $15.14 | $18.62 |
Univera Setting Facility Modifier None Typical Low $18.62 Median $19.05 Typical High $19.05 | Facility | None | $18.62 | $19.05 | $19.05 |
Univera Setting Professional Modifier None Typical Low $10.23 Median $19.95 Typical High $20.89 | Professional | None | $10.23 | $19.95 | $20.89 |
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 $8.71 Median $8.71 Typical High $11.75 | Professional | 52 · Reduced service | $8.71 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $4.68 | Professional | 53 · Discontinued | $3.47 | $3.47 | $4.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.18 Median $13.18 Typical High $17.78 | Professional | 54 · Surgery only | $13.18 | $13.18 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $3.55 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $2.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.04 Median $2.14 Typical High $2.51 | Professional | RR · Rental | $2.04 | $2.14 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $18.20 Typical High $19.05 | Professional | UE · Used equipment | $15.49 | $18.20 | $19.05 |
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
$10.00
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.