How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $1
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 $0.17 Median $0.31 Typical High $0.52 | Facility | None | $0.17 | $0.31 | $0.52 |
Aetna Setting Professional Modifier None Typical Low $0.17 Median $0.25 Typical High $0.52 | Professional | None | $0.17 | $0.25 | $0.52 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.17 Typical High $0.17 | Professional | RR · Rental | $0.05 | $0.17 | $0.17 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | None | $38.02 | $38.02 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.22 Median $0.50 Typical High $1.05 | Professional | None | $0.22 | $0.50 | $1.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.98 Median $1.05 Typical High $1.05 | Professional | RR · Rental | $0.98 | $1.05 | $1.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.16 Median $0.22 Typical High $0.23 | Professional | UE · Used equipment | $0.16 | $0.22 | $0.23 |
Cigna Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Facility | None | $0.81 | $0.81 | $0.81 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Emblem Health Setting Facility Modifier None Typical Low $0.55 Median $0.83 Typical High $2.00 | Facility | None | $0.55 | $0.83 | $2.00 |
Emblem Health Setting Professional Modifier None Typical Low $0.54 Median $0.79 Typical High $1.20 | Professional | None | $0.54 | $0.79 | $1.20 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Facility | None | $0.43 | $0.43 | $0.43 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.42 Median $0.45 Typical High $0.46 | Professional | None | $0.42 | $0.45 | $0.46 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.30 Median $0.50 Typical High $1.23 | Facility | None | $0.30 | $0.50 | $1.23 |
MVP Health Care Setting Facility Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
MVP Health Care Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.79 | Professional | None | $0.28 | $0.28 | $0.79 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.33 Typical High $0.40 | Professional | None | $0.18 | $0.33 | $0.40 |
Univera Setting Facility Modifier None Typical Low $0.42 Median $0.43 Typical High $0.52 | Facility | None | $0.42 | $0.43 | $0.52 |
Univera Setting Professional Modifier None Typical Low $0.42 Median $0.43 Typical High $0.46 | Professional | None | $0.42 | $0.43 | $0.46 |
4 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 $0.13 Median $0.13 Typical High $0.26 | Professional | 52 · Reduced service | $0.13 | $0.13 | $0.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.05 Typical High $0.10 | Professional | 53 · Discontinued | $0.05 | $0.05 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.08 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.05 |
Where New York sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 42nd of 51
$0.31
HI $1.05RI $0.23
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.