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 $30.90 Median $54.95 Typical High $64.57 | Facility | None | $30.90 | $54.95 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | None | $54.95 | $54.95 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $218.78 | Facility | None | $109.65 | $109.65 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $45.71 | Professional | None | $35.48 | $41.69 | $45.71 |
CDPHP Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Emblem Health Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $398.11 | Facility | None | $109.65 | $181.97 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $147.91 | Professional | None | $109.65 | $120.23 | $147.91 |
Excellus BCBS Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $93.33 | Professional | None | $61.66 | $66.07 | $93.33 |
MVP Health Care Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $144.54 | Professional | None | $64.57 | $64.57 | $144.54 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $190.55 | Facility | None | $147.91 | $147.91 | $190.55 |
United Setting Professional Modifier None Typical Low $15.14 Median $53.70 Typical High $72.44 | Professional | None | $15.14 | $53.70 | $72.44 |
Univera Setting Facility Modifier None Typical Low $67.61 Median $109.65 Typical High $109.65 | Facility | None | $67.61 | $109.65 | $109.65 |
Univera Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $109.65 | Professional | None | $61.66 | $66.07 | $109.65 |
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 $27.54 Median $27.54 Typical High $32.36 | Professional | 52 · Reduced service | $27.54 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $13.18 | Professional | 53 · Discontinued | $11.22 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $9.77 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $89.13 Typical High $109.65 | Professional | UE · Used equipment | $66.07 | $89.13 | $109.65 |
Where New York sits
The same service costs 4.2 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
$45.71
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.