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 $24.55 Median $43.65 Typical High $51.29 | Facility | None | $24.55 | $43.65 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | None | $43.65 | $43.65 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $173.78 | Facility | None | $87.10 | $87.10 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $36.31 | Professional | None | $27.54 | $32.36 | $36.31 |
CDPHP Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Emblem Health Setting Facility Modifier None Typical Low $87.10 Median $144.54 Typical High $316.23 | Facility | None | $87.10 | $144.54 | $316.23 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $123.03 | Professional | None | $89.13 | $95.50 | $123.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $74.13 | Professional | None | $48.98 | $51.29 | $74.13 |
MVP Health Care Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $87.10 | Professional | None | $50.12 | $50.12 | $87.10 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $114.82 | Facility | None | $89.13 | $89.13 | $114.82 |
United Setting Professional Modifier None Typical Low $12.02 Median $42.66 Typical High $56.23 | Professional | None | $12.02 | $42.66 | $56.23 |
Univera Setting Facility Modifier None Typical Low $53.70 Median $87.10 Typical High $87.10 | Facility | None | $53.70 | $87.10 | $87.10 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $87.10 | Professional | None | $44.67 | $51.29 | $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 $21.88 Median $21.88 Typical High $25.70 | Professional | 52 · Reduced service | $21.88 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $10.23 | Professional | 53 · Discontinued | $8.71 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $7.76 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $5.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $53.70 Typical High $66.07 | Professional | UE · Used equipment | $40.74 | $53.70 | $66.07 |
Where New York sits
The same service costs 2.8 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· 45th of 51
$34.67
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.