How much rates vary
Facilitymedian $26 · 10th to 90th $24 to $54Professionalmedian $9 · 10th to 90th $8 to $23
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 $16.22 Median $21.88 Typical High $33.88 | Facility | None | $16.22 | $21.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $21.88 | Professional | None | $16.22 | $16.22 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $8.91 Typical High $11.75 | Professional | None | $7.41 | $8.91 | $11.75 |
CDPHP Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Emblem Health Setting Facility Modifier None Typical Low $23.99 Median $35.48 Typical High $85.11 | Facility | None | $23.99 | $35.48 | $85.11 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $28.84 Typical High $44.67 | Professional | None | $22.39 | $28.84 | $44.67 |
Excellus BCBS Setting Professional Modifier None Typical Low $19.50 Median $26.30 Typical High $28.18 | Professional | None | $19.50 | $26.30 | $28.18 |
Highmark BCBS Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
MVP Health Care Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $34.67 | Professional | None | $10.00 | $10.00 | $34.67 |
United Setting Professional Modifier None Typical Low $7.76 Median $14.13 Typical High $18.20 | Professional | None | $7.76 | $14.13 | $18.20 |
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 $26.30 Typical High $28.18 | Professional | None | $14.13 | $26.30 | $28.18 |
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 $8.13 Median $8.13 Typical High $10.96 | Professional | 52 · Reduced service | $8.13 | $8.13 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $4.37 | Professional | 53 · Discontinued | $3.24 | $3.24 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $12.30 Typical High $16.60 | Professional | 54 · Surgery only | $12.30 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $3.31 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.95 Median $2.04 Typical High $2.40 | Professional | RR · Rental | $1.95 | $2.04 | $2.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.45 Median $15.14 Typical High $17.78 | Professional | UE · Used equipment | $14.45 | $15.14 | $17.78 |
Where New York sits
The same service costs 2.9 times more in Rhode Island 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
$9.33
RI $26.92NY $9.33
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.