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 $14.79 Median $32.36 Typical High $109.65 | Facility | None | $14.79 | $32.36 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $32.36 | Professional | None | $14.79 | $14.79 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $58.88 | Professional | None | $15.85 | $15.85 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.58 Median $1.58 Typical High $3.47 | Professional | RR · Rental | $1.58 | $1.58 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.02 Median $12.02 Typical High $21.38 | Professional | UE · Used equipment | $12.02 | $12.02 | $21.38 |
CDPHP Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $21.38 Typical High $22.91 | Facility | None | $12.59 | $21.38 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $52.48 Typical High $125.89 | Facility | None | $34.67 | $52.48 | $125.89 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $61.66 | Professional | None | $22.39 | $36.31 | $61.66 |
Excellus BCBS Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Excellus BCBS Setting Professional Modifier None Typical Low $11.75 Median $19.50 Typical High $28.18 | Professional | None | $11.75 | $19.50 | $28.18 |
MVP Health Care Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
MVP Health Care Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $51.29 | Professional | None | $22.39 | $22.39 | $51.29 |
United Setting Professional Modifier None Typical Low $11.22 Median $20.89 Typical High $26.92 | Professional | None | $11.22 | $20.89 | $26.92 |
Univera Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $19.50 | Facility | None | $11.75 | $11.75 | $19.50 |
Univera Setting Professional Modifier None Typical Low $11.75 Median $19.50 Typical High $28.18 | Professional | None | $11.75 | $19.50 | $28.18 |
3 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 $2.24 Median $2.24 Typical High $4.79 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.48 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.48 | $1.48 | $3.24 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $19.05 Median $19.05 Typical High $85.11 | Professional | KX · Policy requirements met | $19.05 | $19.05 | $85.11 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 35th of 51
$19.50
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.