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 $25.70 Median $45.71 Typical High $53.70 | Facility | None | $25.70 | $45.71 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | None | $45.71 | $45.71 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $181.97 | Facility | None | $91.20 | $91.20 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $38.02 | Professional | None | $28.84 | $33.88 | $38.02 |
CDPHP Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Emblem Health Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $331.13 | Facility | None | $91.20 | $151.36 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $123.03 | Professional | None | $91.20 | $100.00 | $123.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $77.62 | Professional | None | $51.29 | $53.70 | $77.62 |
MVP Health Care Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $95.50 | Professional | None | $52.48 | $52.48 | $95.50 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $125.89 | Facility | None | $97.72 | $97.72 | $125.89 |
United Setting Professional Modifier None Typical Low $12.02 Median $44.67 Typical High $58.88 | Professional | None | $12.02 | $44.67 | $58.88 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $91.20 Typical High $91.20 | Facility | None | $54.95 | $91.20 | $91.20 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $91.20 | Professional | None | $44.67 | $53.70 | $91.20 |
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 $22.91 Median $22.91 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $8.13 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $60.26 Typical High $74.13 | Professional | UE · Used equipment | $43.65 | $60.26 | $74.13 |
Where New York sits
The same service costs 2.9 times more in Hawaii 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· 48th of 51
$36.31
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.