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 $20.89 Median $37.15 Typical High $43.65 | Facility | None | $20.89 | $37.15 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $147.91 | Facility | None | $74.13 | $74.13 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $109.65 | Professional | None | $60.26 | $60.26 | $109.65 |
CDPHP Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Emblem Health Setting Facility Modifier None Typical Low $74.13 Median $123.03 Typical High $269.15 | Facility | None | $74.13 | $123.03 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $107.15 | Professional | None | $77.62 | $81.28 | $107.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $63.10 | Professional | None | $41.69 | $46.77 | $63.10 |
MVP Health Care Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
MVP Health Care Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $97.72 | Professional | None | $43.65 | $43.65 | $97.72 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $128.82 | Facility | None | $100.00 | $100.00 | $128.82 |
United Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $48.98 | Professional | None | $30.20 | $39.81 | $48.98 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $74.13 Typical High $74.13 | Facility | None | $45.71 | $74.13 | $74.13 |
Univera Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $74.13 | Professional | None | $37.15 | $46.77 | $74.13 |
6 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 $18.62 Median $18.62 Typical High $21.88 | Professional | 52 · Reduced service | $18.62 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $8.91 | Professional | 53 · Discontinued | $7.59 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $6.61 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | RR · Rental | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Where New York sits
The same service costs 2.8 times more in Montana than in Alabama. 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· 38th of 51
$43.65
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.