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 $37.15 Median $66.07 Typical High $77.62 | Facility | None | $37.15 | $66.07 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $77.62 | Professional | None | $66.07 | $66.07 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $263.03 | Facility | None | $131.83 | $131.83 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $54.95 | Professional | None | $41.69 | $48.98 | $54.95 |
CDPHP Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Emblem Health Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $478.63 | Facility | None | $131.83 | $218.78 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $186.21 | Professional | None | $131.83 | $144.54 | $186.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $112.20 | Professional | None | $74.13 | $77.62 | $112.20 |
MVP Health Care Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $134.90 | Professional | None | $77.62 | $77.62 | $134.90 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $177.83 | Facility | None | $138.04 | $138.04 | $177.83 |
United Setting Professional Modifier None Typical Low $12.02 Median $64.57 Typical High $85.11 | Professional | None | $12.02 | $64.57 | $85.11 |
Univera Setting Facility Modifier None Typical Low $81.28 Median $131.83 Typical High $131.83 | Facility | None | $81.28 | $131.83 | $131.83 |
Univera Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $131.83 | Professional | None | $74.13 | $77.62 | $131.83 |
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 $33.11 Median $33.11 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $83.18 Typical High $102.33 | Professional | UE · Used equipment | $63.10 | $83.18 | $102.33 |
Where New York sits
The same service costs 2.6 times more in Hawaii 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· 44th of 51
$52.48
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.