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 $8.13 Median $10.96 Typical High $16.98 | Facility | None | $8.13 | $10.96 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | None | $8.13 | $8.13 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.72 Median $4.47 Typical High $5.25 | Professional | None | $3.72 | $4.47 | $5.25 |
CDPHP Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Emblem Health Setting Facility Modifier None Typical Low $12.02 Median $17.78 Typical High $42.66 | Facility | None | $12.02 | $17.78 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $12.59 Median $14.13 Typical High $22.39 | Professional | None | $12.59 | $14.13 | $22.39 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.77 Median $12.88 Typical High $13.80 | Professional | None | $9.77 | $12.88 | $13.80 |
MVP Health Care Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $17.38 | Professional | None | $10.00 | $10.00 | $17.38 |
United Setting Professional Modifier None Typical Low $3.89 Median $7.08 Typical High $9.12 | Professional | None | $3.89 | $7.08 | $9.12 |
Univera Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $13.80 | Facility | None | $12.88 | $12.88 | $13.80 |
Univera Setting Professional Modifier None Typical Low $7.08 Median $12.88 Typical High $13.80 | Professional | None | $7.08 | $12.88 | $13.80 |
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 $4.07 Median $4.07 Typical High $5.50 | Professional | 52 · Reduced service | $4.07 | $4.07 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $2.19 | Professional | 53 · Discontinued | $1.62 | $1.62 | $2.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.03 Median $6.03 Typical High $8.32 | Professional | 54 · Surgery only | $6.03 | $6.03 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.66 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $1.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.95 Median $1.00 Typical High $1.20 | Professional | RR · Rental | $0.95 | $1.00 | $1.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.24 Median $8.51 Typical High $8.91 | Professional | UE · Used equipment | $7.24 | $8.51 | $8.91 |
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
$4.68
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.