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 $4.27 Median $4.79 Typical High $9.33 | Facility | None | $4.27 | $4.79 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $9.33 | Professional | None | $4.27 | $4.27 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.80 Median $5.13 Typical High $16.98 | Professional | None | $3.80 | $5.13 | $16.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.38 Median $0.38 Typical High $0.85 | Professional | RR · Rental | $0.38 | $0.38 | $0.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.69 Median $2.69 Typical High $5.25 | Professional | UE · Used equipment | $2.69 | $2.69 | $5.25 |
CDPHP Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $6.31 | Facility | None | $5.89 | $5.89 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Emblem Health Setting Facility Modifier None Typical Low $10.00 Median $14.79 Typical High $36.31 | Facility | None | $10.00 | $14.79 | $36.31 |
Emblem Health Setting Professional Modifier None Typical Low $6.46 Median $10.47 Typical High $17.78 | Professional | None | $6.46 | $10.47 | $17.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | None | $5.62 | $5.62 | $8.13 |
MVP Health Care Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
MVP Health Care Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $14.45 | Professional | None | $6.03 | $6.03 | $14.45 |
United Setting Professional Modifier None Typical Low $3.24 Median $6.03 Typical High $7.59 | Professional | None | $3.24 | $6.03 | $7.59 |
Univera Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $6.76 | Facility | None | $5.62 | $5.62 | $6.76 |
Univera Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | None | $5.62 | $5.62 | $8.13 |
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 $0.65 Median $0.65 Typical High $1.38 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.91 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | KX · Policy requirements met | $5.37 | $5.37 | $5.37 |
Where New York sits
The same service costs 2.4 times more in Kansas 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· 34th of 51
$5.62
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.