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 $26.30 Median $46.77 Typical High $54.95 | Facility | None | $26.30 | $46.77 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | None | $46.77 | $46.77 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $186.21 | Facility | None | $93.33 | $93.33 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $38.90 | Professional | None | $30.20 | $35.48 | $38.90 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Emblem Health Setting Facility Modifier None Typical Low $93.33 Median $154.88 Typical High $338.84 | Facility | None | $93.33 | $154.88 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $134.90 | Professional | None | $93.33 | $102.33 | $134.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
MVP Health Care Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $117.49 | Professional | None | $54.95 | $54.95 | $117.49 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $158.49 | Facility | None | $120.23 | $120.23 | $158.49 |
United Setting Professional Modifier None Typical Low $10.00 Median $45.71 Typical High $60.26 | Professional | None | $10.00 | $45.71 | $60.26 |
Univera Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $93.33 | Facility | None | $57.54 | $93.33 | $93.33 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $52.48 Typical High $79.43 | Professional | None | $25.12 | $52.48 | $79.43 |
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 $23.44 Median $23.44 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | 53 · Discontinued | $9.33 | $9.33 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $56.23 Median $74.13 Typical High $91.20 | Professional | UE · Used equipment | $56.23 | $74.13 | $91.20 |
Where New York sits
The same service costs 3.5 times more in Hawaii 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
$38.02
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.