How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $3.39 Median $134.90 Typical High $389.05 | Facility | None | $3.39 | $134.90 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $6.92 Typical High $6.92 | Professional | None | $3.39 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $6.92 Typical High $85.11 | Professional | None | $5.89 | $6.92 | $85.11 |
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 $9.77 Median $125.89 Typical High $204.17 | Facility | None | $9.77 | $125.89 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $7.76 Typical High $21.38 | Professional | None | $4.68 | $7.76 | $21.38 |
Emblem Health Setting Facility Modifier None Typical Low $7.08 Median $26.92 Typical High $40.74 | Facility | None | $7.08 | $26.92 | $40.74 |
Emblem Health Setting Professional Modifier None Typical Low $7.08 Median $7.24 Typical High $14.13 | Professional | None | $7.08 | $7.24 | $14.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.27 Median $5.75 Typical High $39.81 | Professional | None | $4.27 | $5.75 | $39.81 |
MVP Health Care Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
MVP Health Care Setting Professional Modifier None Typical Low $8.71 Median $19.95 Typical High $19.95 | Professional | None | $8.71 | $19.95 | $19.95 |
United Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $7.76 | Facility | None | $6.03 | $6.03 | $7.76 |
United Setting Professional Modifier None Typical Low $5.01 Median $8.13 Typical High $16.98 | Professional | None | $5.01 | $8.13 | $16.98 |
Univera Setting Facility Modifier None Typical Low $3.31 Median $7.24 Typical High $23.44 | Facility | None | $3.31 | $7.24 | $23.44 |
Univera Setting Professional Modifier None Typical Low $3.55 Median $5.75 Typical High $39.81 | Professional | None | $3.55 | $5.75 | $39.81 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | GO · Occupational therapy plan | $4.57 | $4.57 | $4.57 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $6.31 Median $6.31 Typical High $6.92 | Professional | 59 · Distinct service | $6.31 | $6.31 | $6.92 |
Highmark BCBS Setting Facility Modifier GO · Occupational therapy plan Typical Low $3.24 Median $6.17 Typical High $309.03 | Facility | GO · Occupational therapy plan | $3.24 | $6.17 | $309.03 |
Highmark BCBS Setting Professional Modifier GP · Physical therapy plan Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | GP · Physical therapy plan | $4.79 | $4.79 | $4.79 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.89 Typical High $4.47 | Professional | 53 · Discontinued | $3.02 | $3.89 | $4.47 |
Where New York sits
The same service costs 2.6 times more in North Dakota than in Missouri. 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· 22nd of 51
$6.92
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.