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 $0.91 Median $1.38 Typical High $2.14 | Facility | None | $0.91 | $1.38 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.14 | Professional | None | $1.38 | $1.38 | $2.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $10.00 | Professional | None | $5.62 | $5.75 | $10.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.56 Median $0.56 Typical High $1.00 | Professional | RR · Rental | $0.56 | $0.56 | $1.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.17 Median $4.17 Typical High $7.24 | Professional | UE · Used equipment | $4.17 | $4.17 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $0.87 Median $1.70 Typical High $1.70 | Professional | None | $0.87 | $1.70 | $1.70 |
Emblem Health Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.70 Median $1.82 Typical High $3.02 | Professional | None | $1.70 | $1.82 | $3.02 |
MVP Health Care Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
MVP Health Care Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.55 Typical High $2.45 | Professional | None | $1.02 | $1.55 | $2.45 |
Univera Setting Facility Modifier None Typical Low $1.70 Median $3.02 Typical High $3.02 | Facility | None | $1.70 | $3.02 | $3.02 |
Univera Setting Professional Modifier None Typical Low $1.70 Median $1.82 Typical High $3.02 | Professional | None | $1.70 | $1.82 | $3.02 |
2 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 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.32 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.21 |
Where New York sits
The same service costs 6.6 times more in Kentucky than in West Virginia. 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· 5th of 51
$3.02
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.