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 $38.02 Median $67.61 Typical High $79.43 | Facility | None | $38.02 | $67.61 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | None | $67.61 | $67.61 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $269.15 | Facility | None | $134.90 | $134.90 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $56.23 | Professional | None | $43.65 | $51.29 | $56.23 |
CDPHP Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
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 $134.90 Median $223.87 Typical High $489.78 | Facility | None | $134.90 | $223.87 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $194.98 | Professional | None | $141.25 | $147.91 | $194.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $114.82 | Professional | None | $75.86 | $81.28 | $114.82 |
MVP Health Care Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $144.54 | Professional | None | $79.43 | $79.43 | $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 $47.86 Median $70.79 Typical High $87.10 | Professional | None | $47.86 | $70.79 | $87.10 |
Univera Setting Facility Modifier None Typical Low $83.18 Median $134.90 Typical High $134.90 | Facility | None | $83.18 | $134.90 | $134.90 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $81.28 Typical High $134.90 | Professional | None | $25.12 | $81.28 | $134.90 |
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 $33.88 Median $33.88 Typical High $39.81 | Professional | 52 · Reduced service | $33.88 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $16.22 | Professional | 53 · Discontinued | $13.80 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $89.13 Typical High $109.65 | Professional | UE · Used equipment | $61.66 | $89.13 | $109.65 |
Where New York sits
The same service costs 3.2 times more in Hawaii than in Arizona. 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· 44th of 51
$53.70
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.