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 $5.37 Median $6.03 Typical High $11.75 | Facility | None | $5.37 | $6.03 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $11.75 | Professional | None | $5.37 | $5.37 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $21.38 | Professional | None | $5.37 | $5.37 | $21.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.54 Median $0.54 Typical High $1.20 | Professional | RR · Rental | $0.54 | $0.54 | $1.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.98 Median $3.98 Typical High $8.71 | Professional | UE · Used equipment | $3.98 | $3.98 | $8.71 |
CDPHP Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
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 $5.13 Typical High $5.13 | Professional | None | $5.01 | $5.13 | $5.13 |
Emblem Health Setting Facility Modifier None Typical Low $12.59 Median $19.05 Typical High $45.71 | Facility | None | $12.59 | $19.05 | $45.71 |
Emblem Health Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $22.91 | Professional | None | $8.32 | $11.75 | $22.91 |
Excellus BCBS Setting Professional Modifier None Typical Low $7.08 Median $7.59 Typical High $10.47 | Professional | None | $7.08 | $7.59 | $10.47 |
MVP Health Care Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $18.62 | Professional | None | $8.32 | $8.32 | $18.62 |
United Setting Professional Modifier None Typical Low $4.17 Median $7.76 Typical High $9.55 | Professional | None | $4.17 | $7.76 | $9.55 |
Univera Setting Facility Modifier None Typical Low $7.08 Median $7.24 Typical High $8.91 | Facility | None | $7.08 | $7.24 | $8.91 |
Univera Setting Professional Modifier None Typical Low $4.27 Median $7.59 Typical High $10.47 | Professional | None | $4.27 | $7.59 | $10.47 |
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 $0.81 Median $0.81 Typical High $1.78 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $1.17 |
Where New York sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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· 20th of 51
$7.24
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.