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 $8.32 Median $8.71 Typical High $17.78 | Facility | None | $8.32 | $8.71 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $17.78 | Professional | None | $8.32 | $8.32 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $32.36 | Professional | None | $9.33 | $9.33 | $32.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.93 Median $0.93 Typical High $2.04 | Professional | RR · Rental | $0.93 | $0.93 | $2.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.08 Median $7.08 Typical High $15.14 | Professional | UE · Used equipment | $7.08 | $7.08 | $15.14 |
CDPHP Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $12.30 Typical High $13.18 | Facility | None | $8.91 | $12.30 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Emblem Health Setting Facility Modifier None Typical Low $19.50 Median $28.84 Typical High $69.18 | Facility | None | $19.50 | $28.84 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $12.59 Median $20.42 Typical High $33.88 | Professional | None | $12.59 | $20.42 | $33.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.03 Median $10.96 Typical High $15.85 | Professional | None | $6.03 | $10.96 | $15.85 |
MVP Health Care Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
MVP Health Care Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $28.18 | Professional | None | $12.59 | $12.59 | $28.18 |
United Setting Professional Modifier None Typical Low $6.31 Median $11.75 Typical High $14.79 | Professional | None | $6.31 | $11.75 | $14.79 |
Univera Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $10.96 | Facility | None | $6.03 | $6.03 | $10.96 |
Univera Setting Professional Modifier None Typical Low $6.03 Median $10.96 Typical High $15.85 | Professional | None | $6.03 | $10.96 | $15.85 |
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 $1.23 Median $1.23 Typical High $2.69 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $1.78 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $1.78 |
Where New York sits
The same service costs 3.0 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· 36th of 51
$10.96
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.