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 $67.61 Median $120.23 Typical High $141.25 | Facility | None | $67.61 | $120.23 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | None | $120.23 | $120.23 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $478.63 | Facility | None | $239.88 | $239.88 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $100.00 | Professional | None | $75.86 | $91.20 | $100.00 |
CDPHP Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Emblem Health Setting Facility Modifier None Typical Low $239.88 Median $398.11 Typical High $870.96 | Facility | None | $239.88 | $398.11 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $323.59 | Professional | None | $239.88 | $263.03 | $323.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
MVP Health Care Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $234.42 | Professional | None | $141.25 | $141.25 | $234.42 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $309.03 | Facility | None | $239.88 | $239.88 | $309.03 |
United Setting Professional Modifier None Typical Low $15.14 Median $117.49 Typical High $154.88 | Professional | None | $15.14 | $117.49 | $154.88 |
Univera Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $239.88 | Facility | None | $147.91 | $239.88 | $239.88 |
Univera Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $204.17 | Professional | None | $134.90 | $134.90 | $204.17 |
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 $60.26 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $60.26 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $144.54 Typical High $177.83 | Professional | UE · Used equipment | $100.00 | $144.54 | $177.83 |
Where New York sits
The same service costs 5.0 times more in Hawaii than in Florida. 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· 42nd of 51
$95.50
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.