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 $23.99 Median $42.66 Typical High $50.12 | Facility | None | $23.99 | $42.66 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $50.12 | Professional | None | $42.66 | $42.66 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $169.82 | Facility | None | $85.11 | $85.11 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $35.48 | Professional | None | $27.54 | $32.36 | $35.48 |
CDPHP Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $309.03 | Facility | None | $85.11 | $141.25 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | None | $93.33 | $93.33 | $123.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
MVP Health Care Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | None | $50.12 | $50.12 | $83.18 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $112.20 | Facility | None | $85.11 | $85.11 | $112.20 |
United Setting Professional Modifier None Typical Low $15.14 Median $41.69 Typical High $54.95 | Professional | None | $15.14 | $41.69 | $54.95 |
Univera Setting Facility Modifier None Typical Low $52.48 Median $85.11 Typical High $85.11 | Facility | None | $52.48 | $85.11 | $85.11 |
Univera Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $72.44 | Professional | None | $47.86 | $47.86 | $72.44 |
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 $21.38 Median $21.38 Typical High $25.12 | Professional | 52 · Reduced service | $21.38 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $10.23 | Professional | 53 · Discontinued | $8.71 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $52.48 Typical High $64.57 | Professional | UE · Used equipment | $36.31 | $52.48 | $64.57 |
Where New York sits
The same service costs 4.2 times more in Minnesota than in Alaska. 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· 45th of 51
$33.88
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.