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 $26.92 Median $47.86 Typical High $56.23 | Facility | None | $26.92 | $47.86 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | None | $47.86 | $47.86 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $190.55 | Facility | None | $95.50 | $95.50 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $39.81 | Professional | None | $30.20 | $35.48 | $39.81 |
CDPHP Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Emblem Health Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $338.84 | Facility | None | $95.50 | $154.88 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $134.90 | Professional | None | $95.50 | $104.71 | $134.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $79.43 | Professional | None | $52.48 | $56.23 | $79.43 |
MVP Health Care Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $93.33 | Professional | None | $54.95 | $54.95 | $93.33 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $123.03 | Facility | None | $95.50 | $95.50 | $123.03 |
United Setting Professional Modifier None Typical Low $12.02 Median $45.71 Typical High $61.66 | Professional | None | $12.02 | $45.71 | $61.66 |
Univera Setting Facility Modifier None Typical Low $57.54 Median $95.50 Typical High $95.50 | Facility | None | $57.54 | $95.50 | $95.50 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $95.50 | Professional | None | $44.67 | $56.23 | $95.50 |
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 $23.99 Median $23.99 Typical High $28.18 | Professional | 52 · Reduced service | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $11.22 | Professional | 53 · Discontinued | $9.55 | $9.55 | $11.22 |
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 $4.79 Median $4.79 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $58.88 Typical High $70.79 | Professional | UE · Used equipment | $42.66 | $58.88 | $70.79 |
Where New York sits
The same service costs 2.9 times more in Montana than in Nebraska. 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
$37.15
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.