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 $1.45 Median $1.70 Typical High $3.24 | Facility | None | $1.45 | $1.70 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $3.24 | Professional | None | $1.45 | $1.45 | $3.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $5.62 | Professional | None | $1.74 | $1.74 | $5.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.17 Median $0.17 Typical High $0.30 | Professional | RR · Rental | $0.17 | $0.17 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.29 Median $1.29 Typical High $2.24 | Professional | UE · Used equipment | $1.29 | $1.29 | $2.24 |
CDPHP Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Emblem Health Setting Facility Modifier None Typical Low $2.34 Median $3.55 Typical High $7.76 | Facility | None | $2.34 | $3.55 | $7.76 |
Emblem Health Setting Professional Modifier None Typical Low $3.24 Median $4.17 Typical High $6.61 | Professional | None | $3.24 | $4.17 | $6.61 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.24 Typical High $2.88 | Professional | None | $2.09 | $2.24 | $2.88 |
MVP Health Care Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $5.01 | Professional | None | $1.95 | $1.95 | $5.01 |
United Setting Professional Modifier None Typical Low $1.12 Median $2.14 Typical High $2.51 | Professional | None | $1.12 | $2.14 | $2.51 |
Univera Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
Univera Setting Professional Modifier None Typical Low $2.09 Median $2.24 Typical High $2.88 | Professional | None | $2.09 | $2.24 | $2.88 |
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 $0.72 Median $0.72 Typical High $1.62 | Professional | 52 · Reduced service | $0.72 | $0.72 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.65 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.49 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.33 |
Where New York sits
The same service costs 2.3 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· 39th of 51
$2.00
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.