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 $30.20 Median $53.70 Typical High $63.10 | Facility | None | $30.20 | $53.70 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | None | $53.70 | $53.70 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $213.80 | Facility | None | $107.15 | $107.15 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $44.67 | Professional | None | $33.88 | $39.81 | $44.67 |
CDPHP Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Emblem Health Setting Facility Modifier None Typical Low $107.15 Median $173.78 Typical High $380.19 | Facility | None | $107.15 | $173.78 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $151.36 | Professional | None | $100.00 | $100.00 | $151.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $91.20 | Professional | None | $60.26 | $63.10 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $107.15 | Professional | None | $61.66 | $61.66 | $107.15 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $141.25 | Facility | None | $109.65 | $109.65 | $141.25 |
United Setting Professional Modifier None Typical Low $15.14 Median $52.48 Typical High $69.18 | Professional | None | $15.14 | $52.48 | $69.18 |
Univera Setting Facility Modifier None Typical Low $64.57 Median $107.15 Typical High $107.15 | Facility | None | $64.57 | $107.15 | $107.15 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $107.15 | Professional | None | $60.26 | $63.10 | $107.15 |
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 $26.92 Median $26.92 Typical High $31.62 | Professional | 52 · Reduced service | $26.92 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | 53 · Discontinued | $10.72 | $10.72 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $9.33 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $6.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $67.61 Typical High $83.18 | Professional | UE · Used equipment | $50.12 | $67.61 | $83.18 |
Where New York sits
The same service costs 2.7 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· 46th of 51
$42.66
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.