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 $81.28 Median $144.54 Typical High $169.82 | Facility | None | $81.28 | $144.54 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | None | $144.54 | $144.54 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $575.44 | Facility | None | $288.40 | $288.40 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $120.23 | Professional | None | $93.33 | $109.65 | $120.23 |
CDPHP Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Emblem Health Setting Facility Modifier None Typical Low $288.40 Median $478.63 Typical High $1,047.13 | Facility | None | $288.40 | $478.63 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | None | $316.23 | $316.23 | $416.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $281.84 | Professional | None | $169.82 | $169.82 | $281.84 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $371.54 | Facility | None | $288.40 | $288.40 | $371.54 |
United Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $186.21 | Professional | None | $97.72 | $151.36 | $186.21 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $288.40 | Facility | None | $177.83 | $288.40 | $288.40 |
Univera Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $245.47 | Professional | None | $162.18 | $162.18 | $245.47 |
8 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 $72.44 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $28.84 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $16.98 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $123.03 Median $177.83 Typical High $218.78 | Professional | UE · Used equipment | $123.03 | $177.83 | $218.78 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where New York sits
The same service costs 3.3 times more in Alaska 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· 43rd of 51
$115
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.