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 $28.84 Median $51.29 Typical High $60.26 | Facility | None | $28.84 | $51.29 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | None | $51.29 | $51.29 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $204.17 | Facility | None | $102.33 | $102.33 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $42.66 | Professional | None | $33.11 | $38.90 | $42.66 |
CDPHP Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $169.82 Typical High $371.54 | Facility | None | $102.33 | $169.82 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $138.04 | Professional | None | $102.33 | $112.20 | $138.04 |
Excellus 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 $60.26 Median $60.26 Typical High $117.49 | Professional | None | $60.26 | $60.26 | $117.49 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $154.88 | Facility | None | $120.23 | $120.23 | $154.88 |
United Setting Professional Modifier None Typical Low $10.00 Median $50.12 Typical High $66.07 | Professional | None | $10.00 | $50.12 | $66.07 |
Univera Setting Facility Modifier None Typical Low $63.10 Median $102.33 Typical High $102.33 | Facility | None | $63.10 | $102.33 | $102.33 |
Univera Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $87.10 | Professional | None | $57.54 | $57.54 | $87.10 |
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 $25.70 Median $25.70 Typical High $30.20 | Professional | 52 · Reduced service | $25.70 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | 53 · Discontinued | $10.23 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $9.12 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $72.44 Typical High $89.13 | Professional | UE · Used equipment | $50.12 | $72.44 | $89.13 |
Where New York sits
The same service costs 3.2 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
$41.69
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.