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 $19.95 Median $35.48 Typical High $41.69 | Facility | None | $19.95 | $35.48 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $41.69 | Professional | None | $35.48 | $35.48 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $141.25 | Facility | None | $70.79 | $70.79 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $26.92 Typical High $29.51 | Professional | None | $22.39 | $26.92 | $29.51 |
CDPHP Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Emblem Health Setting Facility Modifier None Typical Low $70.79 Median $117.49 Typical High $257.04 | Facility | None | $70.79 | $117.49 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | None | $77.62 | $77.62 | $95.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $60.26 | Professional | None | $39.81 | $41.69 | $60.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
MVP Health Care Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $69.18 | Professional | None | $41.69 | $41.69 | $69.18 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $91.20 | Facility | None | $70.79 | $70.79 | $91.20 |
United Setting Professional Modifier None Typical Low $10.00 Median $34.67 Typical High $45.71 | Professional | None | $10.00 | $34.67 | $45.71 |
Univera Setting Facility Modifier None Typical Low $43.65 Median $70.79 Typical High $70.79 | Facility | None | $43.65 | $70.79 | $70.79 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $41.69 Typical High $70.79 | Professional | None | $25.12 | $41.69 | $70.79 |
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 $17.78 Median $17.78 Typical High $20.89 | Professional | 52 · Reduced service | $17.78 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | 53 · Discontinued | $7.08 | $7.08 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $6.31 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $4.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.11 Median $42.66 Typical High $52.48 | Professional | UE · Used equipment | $33.11 | $42.66 | $52.48 |
Where New York sits
The same service costs 3.0 times more in Hawaii 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· 45th of 51
$28.18
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.