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 $10.72 Median $12.59 Typical High $25.12 | Facility | None | $10.72 | $12.59 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $25.12 | Professional | None | $10.72 | $10.72 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $42.66 | Professional | None | $12.88 | $12.88 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.29 Median $1.29 Typical High $2.29 | Professional | RR · Rental | $1.29 | $1.29 | $2.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.55 Median $9.55 Typical High $16.60 | Professional | UE · Used equipment | $9.55 | $9.55 | $16.60 |
CDPHP Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Emblem Health Setting Facility Modifier None Typical Low $17.78 Median $26.30 Typical High $57.54 | Facility | None | $17.78 | $26.30 | $57.54 |
Emblem Health Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $48.98 | Professional | None | $25.70 | $28.18 | $48.98 |
Excellus BCBS Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $15.49 Median $22.39 Typical High $25.70 | Professional | None | $15.49 | $22.39 | $25.70 |
MVP Health Care Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
MVP Health Care Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $37.15 | Professional | None | $14.45 | $14.45 | $37.15 |
United Setting Professional Modifier None Typical Low $8.71 Median $16.98 Typical High $19.05 | Professional | None | $8.71 | $16.98 | $19.05 |
Univera Setting Facility Modifier None Typical Low $15.85 Median $25.70 Typical High $25.70 | Facility | None | $15.85 | $25.70 | $25.70 |
Univera Setting Professional Modifier None Typical Low $15.49 Median $22.39 Typical High $25.70 | Professional | None | $15.49 | $22.39 | $25.70 |
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 $5.37 Median $5.37 Typical High $12.59 | Professional | 52 · Reduced service | $5.37 | $5.37 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $5.01 | Professional | 53 · Discontinued | $2.14 | $2.14 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $3.80 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $2.51 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in Kentucky. 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· 29th of 51
$15.14
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.