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 $1.35 Median $1.51 Typical High $10.00 | Facility | None | $1.35 | $1.51 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $2.95 | Professional | None | $1.35 | $1.35 | $2.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $5.37 | Professional | None | $1.38 | $1.38 | $5.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.14 Median $0.14 Typical High $0.30 | Professional | RR · Rental | $0.14 | $0.14 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.05 Median $1.05 Typical High $2.24 | Professional | UE · Used equipment | $1.05 | $1.05 | $2.24 |
CDPHP Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.29 | Facility | None | $1.86 | $1.86 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Emblem Health Setting Facility Modifier None Typical Low $3.16 Median $4.79 Typical High $11.48 | Facility | None | $3.16 | $4.79 | $11.48 |
Emblem Health Setting Professional Modifier None Typical Low $2.04 Median $3.31 Typical High $5.62 | Professional | None | $2.04 | $3.31 | $5.62 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Facility | None | $2.34 | $2.34 | $2.34 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.78 Median $2.34 Typical High $2.57 | Professional | None | $1.78 | $2.34 | $2.57 |
MVP Health Care Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
MVP Health Care Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $4.57 | Professional | None | $1.91 | $1.91 | $4.57 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.91 Typical High $2.34 | Professional | None | $1.02 | $1.91 | $2.34 |
Univera Setting Facility Modifier None Typical Low $1.78 Median $2.34 Typical High $2.34 | Facility | None | $1.78 | $2.34 | $2.34 |
Univera Setting Professional Modifier None Typical Low $1.78 Median $2.34 Typical High $2.57 | Professional | None | $1.78 | $2.34 | $2.57 |
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 $0.20 Median $0.20 Typical High $0.44 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.28 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | KX · Policy requirements met | $1.74 | $1.74 | $1.74 |
Where New York sits
The same service costs 3.0 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· 30th of 51
$1.91
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.