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 $21.88 Median $39.81 Typical High $46.77 | Facility | None | $21.88 | $39.81 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $46.77 | Professional | None | $39.81 | $39.81 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $154.88 | Facility | None | $77.62 | $77.62 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $32.36 | Professional | None | $25.12 | $29.51 | $32.36 |
CDPHP Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Emblem Health Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $281.84 | Facility | None | $77.62 | $128.82 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | None | $85.11 | $85.11 | $104.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $66.07 | Professional | None | $43.65 | $46.77 | $66.07 |
MVP Health Care Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $79.43 | Professional | None | $45.71 | $45.71 | $79.43 |
United Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $104.71 | Facility | None | $81.28 | $81.28 | $104.71 |
United Setting Professional Modifier None Typical Low $10.00 Median $38.02 Typical High $51.29 | Professional | None | $10.00 | $38.02 | $51.29 |
Univera Setting Facility Modifier None Typical Low $47.86 Median $77.62 Typical High $77.62 | Facility | None | $47.86 | $77.62 | $77.62 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $46.77 Typical High $77.62 | Professional | None | $25.12 | $46.77 | $77.62 |
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 $19.50 Median $19.50 Typical High $22.91 | Professional | 52 · Reduced service | $19.50 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.33 | Professional | 53 · Discontinued | $7.94 | $7.94 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $48.98 Typical High $60.26 | Professional | UE · Used equipment | $37.15 | $48.98 | $60.26 |
Where New York sits
The same service costs 2.8 times more in Hawaii than in Utah. 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· 48th of 51
$30.90
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.