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 $8.71 Median $15.49 Typical High $18.20 | Facility | None | $8.71 | $15.49 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $18.20 | Professional | None | $15.49 | $15.49 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $61.66 | Facility | None | $30.90 | $30.90 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $12.88 | Professional | None | $9.77 | $11.48 | $12.88 |
CDPHP Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Emblem Health Setting Facility Modifier None Typical Low $30.90 Median $50.12 Typical High $109.65 | Facility | None | $30.90 | $50.12 | $109.65 |
Emblem Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | None | $33.88 | $33.88 | $44.67 |
Excellus BCBS Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $26.30 | Professional | None | $17.38 | $18.20 | $26.30 |
MVP Health Care Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $30.90 | Professional | None | $17.78 | $17.78 | $30.90 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $41.69 | Facility | None | $31.62 | $31.62 | $41.69 |
United Setting Professional Modifier None Typical Low $10.72 Median $16.22 Typical High $19.95 | Professional | None | $10.72 | $16.22 | $19.95 |
Univera Setting Facility Modifier None Typical Low $18.62 Median $30.90 Typical High $30.90 | Facility | None | $18.62 | $30.90 | $30.90 |
Univera Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $30.90 | Professional | None | $16.60 | $18.20 | $30.90 |
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 $7.76 Median $7.76 Typical High $9.12 | Professional | 52 · Reduced service | $7.76 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.09 Typical High $3.63 | Professional | 53 · Discontinued | $3.09 | $3.09 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.55 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.55 | $1.55 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $19.50 Typical High $23.99 | Professional | UE · Used equipment | $14.79 | $19.50 | $23.99 |
Where New York sits
The same service costs 4.6 times more in Hawaii than in Ohio. 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
$12.30
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.