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 $30.90 Typical High $36.31 | Facility | None | $17.38 | $30.90 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $36.31 | Professional | None | $30.90 | $30.90 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $123.03 | Facility | None | $61.66 | $61.66 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $25.70 | Professional | None | $19.50 | $22.91 | $25.70 |
CDPHP Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Emblem Health Setting Facility Modifier None Typical Low $61.66 Median $102.33 Typical High $223.87 | Facility | None | $61.66 | $102.33 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $89.13 | Professional | None | $67.61 | $67.61 | $89.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $52.48 | Professional | None | $34.67 | $36.31 | $52.48 |
MVP Health Care Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $60.26 | Professional | None | $36.31 | $36.31 | $60.26 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $79.43 | Facility | None | $61.66 | $61.66 | $79.43 |
United Setting Professional Modifier None Typical Low $10.00 Median $30.20 Typical High $39.81 | Professional | None | $10.00 | $30.20 | $39.81 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $61.66 Typical High $61.66 | Facility | None | $38.02 | $61.66 | $61.66 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $36.31 Typical High $61.66 | Professional | None | $25.12 | $36.31 | $61.66 |
5 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 $15.49 Median $15.49 Typical High $18.20 | Professional | 52 · Reduced service | $15.49 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.24 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $28.84 Median $37.15 Typical High $45.71 | Professional | UE · Used equipment | $28.84 | $37.15 | $45.71 |
Where New York sits
The same service costs 3.3 times more in Montana than in Missouri. 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· 44th of 51
$24.55
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.