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 $48.98 Median $87.10 Typical High $102.33 | Facility | None | $48.98 | $87.10 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | None | $87.10 | $87.10 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $346.74 | Facility | None | $173.78 | $173.78 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $72.44 | Professional | None | $56.23 | $66.07 | $72.44 |
CDPHP Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Emblem Health Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $630.96 | Facility | None | $173.78 | $288.40 | $630.96 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $251.19 | Professional | None | $181.97 | $190.55 | $251.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
MVP Health Care Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $186.21 | Professional | None | $104.71 | $104.71 | $186.21 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $251.19 | Facility | None | $190.55 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $15.14 Median $85.11 Typical High $112.20 | Professional | None | $15.14 | $85.11 | $112.20 |
Univera Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $173.78 | Facility | None | $114.82 | $173.78 | $173.78 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $97.72 Typical High $147.91 | Professional | None | $44.67 | $97.72 | $147.91 |
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 $43.65 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $43.65 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $20.42 | Professional | 53 · Discontinued | $17.38 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $117.49 Typical High $144.54 | Professional | UE · Used equipment | $100.00 | $117.49 | $144.54 |
Where New York sits
The same service costs 3.0 times more in Hawaii than in Indiana. 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· 48th of 51
$69.18
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.