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 $23.44 Median $42.66 Typical High $50.12 | Facility | None | $23.44 | $42.66 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $50.12 | Professional | None | $42.66 | $42.66 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $165.96 | Facility | None | $83.18 | $83.18 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $34.67 | Professional | None | $26.92 | $31.62 | $34.67 |
CDPHP Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Emblem Health Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $302.00 | Facility | None | $83.18 | $138.04 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $112.20 | Professional | None | $89.13 | $91.20 | $112.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $70.79 | Professional | None | $46.77 | $50.12 | $70.79 |
Highmark BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
MVP Health Care Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $81.28 | Professional | None | $48.98 | $48.98 | $81.28 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $109.65 | Facility | None | $83.18 | $83.18 | $109.65 |
United Setting Professional Modifier None Typical Low $12.02 Median $40.74 Typical High $54.95 | Professional | None | $12.02 | $40.74 | $54.95 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $83.18 Typical High $83.18 | Facility | None | $51.29 | $83.18 | $83.18 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $83.18 | Professional | None | $44.67 | $50.12 | $83.18 |
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 $20.89 Median $20.89 Typical High $24.55 | Professional | 52 · Reduced service | $20.89 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | 53 · Discontinued | $8.51 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $51.29 Typical High $63.10 | Professional | UE · Used equipment | $35.48 | $51.29 | $63.10 |
Where New York sits
The same service costs 2.8 times more in Montana than in Ohio. 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
$33.11
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.