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 $4.57 Median $8.32 Typical High $9.77 | Facility | None | $4.57 | $8.32 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $9.77 | Professional | None | $8.32 | $8.32 | $9.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $32.36 | Facility | None | $16.22 | $16.22 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $6.17 Typical High $6.76 | Professional | None | $5.25 | $6.17 | $6.76 |
CDPHP Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Emblem Health Setting Facility Modifier None Typical Low $16.22 Median $26.92 Typical High $58.88 | Facility | None | $16.22 | $26.92 | $58.88 |
Emblem Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $23.44 | Professional | None | $17.78 | $17.78 | $23.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
MVP Health Care Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $16.60 | Professional | None | $1.00 | $1.00 | $16.60 |
United Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $21.88 | Facility | None | $16.60 | $16.60 | $21.88 |
United Setting Professional Modifier None Typical Low $3.98 Median $7.94 Typical High $10.72 | Professional | None | $3.98 | $7.94 | $10.72 |
Univera Setting Facility Modifier None Typical Low $10.72 Median $16.22 Typical High $16.22 | Facility | None | $10.72 | $16.22 | $16.22 |
Univera Setting Professional Modifier None Typical Low $1.91 Median $9.12 Typical High $13.80 | Professional | None | $1.91 | $9.12 | $13.80 |
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 $4.07 Median $4.07 Typical High $4.79 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $1.95 | Professional | 53 · Discontinued | $1.66 | $1.66 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.45 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.25 Median $10.23 Typical High $12.59 | Professional | UE · Used equipment | $5.25 | $10.23 | $12.59 |
Where New York sits
The same service costs 2.7 times more in Montana 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· 46th of 51
$6.46
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.