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 $2.04 Median $2.29 Typical High $4.47 | Facility | None | $2.04 | $2.29 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $4.47 | Professional | None | $2.04 | $2.04 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.86 Typical High $6.92 | Professional | None | $1.82 | $1.86 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $0.18 Typical High $0.34 | Professional | RR · Rental | $0.18 | $0.18 | $0.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.38 Median $1.38 Typical High $1.86 | Professional | UE · Used equipment | $1.38 | $1.38 | $1.86 |
CDPHP Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
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 $4.90 Median $7.24 Typical High $17.38 | Facility | None | $4.90 | $7.24 | $17.38 |
Emblem Health Setting Professional Modifier None Typical Low $4.47 Median $5.37 Typical High $9.12 | Professional | None | $4.47 | $5.37 | $9.12 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.69 Median $3.39 Typical High $3.98 | Professional | None | $2.69 | $3.39 | $3.98 |
MVP Health Care Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
MVP Health Care Setting Professional Modifier None Typical Low $5.62 Median $32.36 Typical High $32.36 | Professional | None | $5.62 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.95 Typical High $3.47 | Professional | None | $1.58 | $2.95 | $3.47 |
Univera Setting Facility Modifier None Typical Low $2.75 Median $3.39 Typical High $3.39 | Facility | None | $2.75 | $3.39 | $3.39 |
Univera Setting Professional Modifier None Typical Low $2.69 Median $3.39 Typical High $3.98 | Professional | None | $2.69 | $3.39 | $3.98 |
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 $1.05 Median $1.05 Typical High $2.24 | Professional | 52 · Reduced service | $1.05 | $1.05 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.41 Typical High $0.89 | Professional | 53 · Discontinued | $0.41 | $0.41 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.31 Typical High $0.68 | Professional | 55 · Aftercare only | $0.31 | $0.31 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.45 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 38th of 51
$2.40
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.