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 $28.18 Median $50.12 Typical High $58.88 | Facility | None | $28.18 | $50.12 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $58.88 | Professional | None | $50.12 | $50.12 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $199.53 | Facility | None | $100.00 | $100.00 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $41.69 | Professional | None | $31.62 | $37.15 | $41.69 |
CDPHP Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $165.96 Typical High $363.08 | Facility | None | $100.00 | $165.96 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $141.25 | Professional | None | $100.00 | $109.65 | $141.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $85.11 | Professional | None | $56.23 | $58.88 | $85.11 |
MVP Health Care Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $123.03 | Professional | None | $58.88 | $58.88 | $123.03 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $162.18 | Facility | None | $125.89 | $125.89 | $162.18 |
United Setting Professional Modifier None Typical Low $15.14 Median $48.98 Typical High $64.57 | Professional | None | $15.14 | $48.98 | $64.57 |
Univera Setting Facility Modifier None Typical Low $61.66 Median $100.00 Typical High $100.00 | Facility | None | $61.66 | $100.00 | $100.00 |
Univera Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $100.00 | Professional | None | $56.23 | $58.88 | $100.00 |
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 $25.12 Median $25.12 Typical High $29.51 | Professional | 52 · Reduced service | $25.12 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $11.75 | Professional | 53 · Discontinued | $10.00 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $8.91 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $58.88 Median $75.86 Typical High $93.33 | Professional | UE · Used equipment | $58.88 | $75.86 | $93.33 |
Where New York sits
The same service costs 2.9 times more in Hawaii than in New York. 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· 51st of 51
$41.69
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.