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 $26.30 Median $46.77 Typical High $54.95 | Facility | None | $26.30 | $46.77 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | None | $46.77 | $46.77 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $186.21 | Facility | None | $91.20 | $91.20 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $34.67 Typical High $38.90 | Professional | None | $29.51 | $34.67 | $38.90 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
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 $102.33 Typical High $131.83 | Professional | None | $91.20 | $102.33 | $131.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $77.62 | Professional | None | $51.29 | $54.95 | $77.62 |
MVP Health Care Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $102.33 | Professional | None | $53.70 | $53.70 | $102.33 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $138.04 | Facility | None | $104.71 | $104.71 | $138.04 |
United Setting Professional Modifier None Typical Low $12.02 Median $44.67 Typical High $60.26 | Professional | None | $12.02 | $44.67 | $60.26 |
Univera Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $91.20 | Facility | None | $56.23 | $91.20 | $91.20 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $91.20 | Professional | None | $44.67 | $54.95 | $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 $23.44 Median $23.44 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | 53 · Discontinued | $9.33 | $9.33 | $10.96 |
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 $4.68 Median $4.68 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $48.98 Median $64.57 Typical High $79.43 | Professional | UE · Used equipment | $48.98 | $64.57 | $79.43 |
Where New York sits
The same service costs 2.6 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· 48th of 51
$38.02
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.