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 $23.44 Median $30.90 Typical High $51.29 | Facility | None | $23.44 | $30.90 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $51.29 | Professional | None | $23.44 | $23.44 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $93.33 | Professional | None | $26.92 | $26.92 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $6.17 | Professional | RR · Rental | $2.69 | $2.69 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $36.31 | Professional | UE · Used equipment | $20.42 | $20.42 | $36.31 |
CDPHP Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $40.74 | Facility | None | $34.67 | $38.02 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $83.18 Typical High $199.53 | Facility | None | $54.95 | $83.18 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $36.31 Median $60.26 Typical High $97.72 | Professional | None | $36.31 | $60.26 | $97.72 |
Excellus BCBS Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $44.67 | Professional | None | $31.62 | $38.02 | $44.67 |
MVP Health Care Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
MVP Health Care Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $81.28 | Professional | None | $36.31 | $36.31 | $81.28 |
United Setting Professional Modifier None Typical Low $18.20 Median $33.88 Typical High $44.67 | Professional | None | $18.20 | $33.88 | $44.67 |
Univera Setting Facility Modifier None Typical Low $31.62 Median $38.02 Typical High $38.90 | Facility | None | $31.62 | $38.02 | $38.90 |
Univera Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $44.67 | Professional | None | $31.62 | $38.02 | $44.67 |
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 $3.55 Median $3.55 Typical High $7.76 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $5.13 |
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· 39th of 51
$33.11
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.