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 $26.30 Typical High $29.51 | Professional | None | $22.39 | $26.30 | $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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Emblem Health Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $251.19 | Facility | None | $70.79 | $114.82 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Professional | None | $77.62 | $77.62 | $100.00 |
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 |
MVP Health Care Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $72.44 | Professional | None | $40.74 | $40.74 | $72.44 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Facility | None | $72.44 | $72.44 | $95.50 |
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 $42.66 Median $70.79 Typical High $70.79 | Facility | None | $42.66 | $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 $44.67 Typical High $54.95 | Professional | UE · Used equipment | $33.11 | $44.67 | $54.95 |
Where New York sits
The same service costs 3.3 times more in Montana than in Indiana. 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· 46th 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.