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 $12.30 Median $21.88 Typical High $25.70 | Facility | None | $12.30 | $21.88 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $25.70 | Professional | None | $21.88 | $21.88 | $25.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $87.10 | Facility | None | $43.65 | $43.65 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $18.20 | Professional | None | $13.80 | $16.22 | $18.20 |
CDPHP Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Emblem Health Setting Facility Modifier None Typical Low $43.65 Median $70.79 Typical High $154.88 | Facility | None | $43.65 | $70.79 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $63.10 | Professional | None | $47.86 | $47.86 | $63.10 |
Excellus BCBS Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
MVP Health Care Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $45.71 | Professional | None | $25.12 | $25.12 | $45.71 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $60.26 | Facility | None | $46.77 | $46.77 | $60.26 |
United Setting Professional Modifier None Typical Low $15.85 Median $22.91 Typical High $28.18 | Professional | None | $15.85 | $22.91 | $28.18 |
Univera Setting Facility Modifier None Typical Low $26.30 Median $43.65 Typical High $43.65 | Facility | None | $26.30 | $43.65 | $43.65 |
Univera Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $37.15 | Professional | None | $24.55 | $24.55 | $37.15 |
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 $10.96 Median $10.96 Typical High $12.88 | Professional | 52 · Reduced service | $10.96 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $5.13 | Professional | 53 · Discontinued | $4.37 | $4.37 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.89 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $21.38 Median $28.18 Typical High $34.67 | Professional | UE · Used equipment | $21.38 | $28.18 | $34.67 |
Where New York sits
The same service costs 5.9 times more in Hawaii than in Utah. 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
$17.38
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.