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 $29.51 Median $40.74 Typical High $52.48 | Facility | None | $29.51 | $40.74 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $16.22 Typical High $21.38 | Professional | None | $13.49 | $16.22 | $21.38 |
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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Emblem Health Setting Facility Modifier None Typical Low $43.65 Median $64.57 Typical High $158.49 | Facility | None | $43.65 | $64.57 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $81.28 | Professional | None | $45.71 | $52.48 | $81.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $42.66 | Professional | None | $35.48 | $39.81 | $42.66 |
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 $14.13 Median $26.30 Typical High $31.62 | Professional | None | $14.13 | $26.30 | $31.62 |
Univera Setting Facility Modifier None Typical Low $39.81 Median $40.74 Typical High $43.65 | Facility | None | $39.81 | $40.74 | $43.65 |
Univera Setting Professional Modifier None Typical Low $21.88 Median $39.81 Typical High $42.66 | Professional | None | $21.88 | $39.81 | $42.66 |
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 $14.79 Median $14.79 Typical High $19.95 | Professional | 52 · Reduced service | $14.79 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $8.13 | Professional | 53 · Discontinued | $5.89 | $5.89 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $30.20 | Professional | 54 · Surgery only | $22.39 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $6.03 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $4.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.55 Median $3.72 Typical High $4.37 | Professional | RR · Rental | $3.55 | $3.72 | $4.37 |
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
$16.98
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.