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 $9.33 Median $10.47 Typical High $20.42 | Facility | None | $9.33 | $10.47 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $20.42 | Professional | None | $9.33 | $9.33 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $37.15 | Professional | None | $10.72 | $10.72 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $1.07 Typical High $2.34 | Professional | RR · Rental | $1.07 | $1.07 | $2.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.13 Median $8.13 Typical High $14.45 | Professional | UE · Used equipment | $8.13 | $8.13 | $14.45 |
CDPHP Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $12.02 Median $15.14 Typical High $16.22 | Facility | None | $12.02 | $15.14 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Emblem Health Setting Facility Modifier None Typical Low $21.88 Median $33.11 Typical High $79.43 | Facility | None | $21.88 | $33.11 | $79.43 |
Emblem Health Setting Professional Modifier None Typical Low $14.13 Median $23.99 Typical High $39.81 | Professional | None | $14.13 | $23.99 | $39.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $17.78 | Professional | None | $12.30 | $13.18 | $17.78 |
MVP Health Care Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $31.62 | Professional | None | $14.13 | $14.13 | $31.62 |
United Setting Professional Modifier None Typical Low $7.08 Median $13.18 Typical High $17.38 | Professional | None | $7.08 | $13.18 | $17.38 |
Univera Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $15.49 | Facility | None | $12.30 | $12.30 | $15.49 |
Univera Setting Professional Modifier None Typical Low $7.41 Median $13.18 Typical High $17.78 | Professional | None | $7.41 | $13.18 | $17.78 |
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 $1.41 Median $1.41 Typical High $3.02 | Professional | 55 · Aftercare only | $1.41 | $1.41 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.93 Typical High $2.04 | Professional | 56 · Pre-op care only | $0.93 | $0.93 | $2.04 |
Where New York sits
The same service costs 3.5 times more in Hawaii than in Connecticut. 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
$13.18
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.