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 $39.81 Median $70.79 Typical High $83.18 | Facility | None | $39.81 | $70.79 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | None | $70.79 | $70.79 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $281.84 | Facility | None | $141.25 | $141.25 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $58.88 | Professional | None | $45.71 | $53.70 | $58.88 |
CDPHP Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $234.42 Typical High $512.86 | Facility | None | $141.25 | $234.42 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $190.55 | Professional | None | $141.25 | $154.88 | $190.55 |
Excellus BCBS Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $120.23 | Professional | None | $79.43 | $85.11 | $120.23 |
MVP Health Care Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $173.78 | Professional | None | $83.18 | $83.18 | $173.78 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $229.09 | Facility | None | $173.78 | $173.78 | $229.09 |
United Setting Professional Modifier None Typical Low $15.14 Median $69.18 Typical High $91.20 | Professional | None | $15.14 | $69.18 | $91.20 |
Univera Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $141.25 | Facility | None | $87.10 | $141.25 | $141.25 |
Univera Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $141.25 | Professional | None | $79.43 | $85.11 | $141.25 |
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 $35.48 Median $35.48 Typical High $41.69 | Professional | 52 · Reduced service | $35.48 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $16.60 | Professional | 53 · Discontinued | $14.13 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $91.20 Median $117.49 Typical High $131.83 | Professional | UE · Used equipment | $91.20 | $117.49 | $131.83 |
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
$58.88
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.