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 $21.88 Median $38.90 Typical High $45.71 | Facility | None | $21.88 | $38.90 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | None | $38.90 | $38.90 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $154.88 | Facility | None | $77.62 | $77.62 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $32.36 | Professional | None | $24.55 | $28.84 | $32.36 |
CDPHP Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Emblem Health Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $281.84 | Facility | None | $77.62 | $128.82 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | None | $85.11 | $85.11 | $112.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $93.33 | Professional | None | $46.77 | $46.77 | $93.33 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $123.03 | Facility | None | $95.50 | $95.50 | $123.03 |
United Setting Professional Modifier None Typical Low $10.00 Median $38.02 Typical High $50.12 | Professional | None | $10.00 | $38.02 | $50.12 |
Univera Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $77.62 | Facility | None | $50.12 | $77.62 | $77.62 |
Univera Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $66.07 | Professional | None | $43.65 | $43.65 | $66.07 |
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 $19.50 Median $19.50 Typical High $22.91 | Professional | 52 · Reduced service | $19.50 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $9.12 | Professional | 53 · Discontinued | $7.76 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $4.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $57.54 Typical High $70.79 | Professional | UE · Used equipment | $44.67 | $57.54 | $70.79 |
Where New York sits
The same service costs 3.2 times more in Montana than in New York. 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· 51st of 51
$31.62
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.