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 $0.79 Median $0.89 Typical High $1.70 | Facility | None | $0.79 | $0.89 | $1.70 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.70 | Professional | None | $0.79 | $0.79 | $1.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $2.51 Typical High $3.55 | Professional | None | $1.26 | $2.51 | $3.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.09 Typical High $0.19 | Professional | RR · Rental | $0.09 | $0.09 | $0.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.68 Median $0.95 Typical High $0.95 | Professional | UE · Used equipment | $0.68 | $0.95 | $0.95 |
CDPHP Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.15 | Facility | None | $1.10 | $1.10 | $1.15 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | None | $0.93 | $0.93 | $0.93 |
Emblem Health Setting Facility Modifier None Typical Low $1.82 Median $2.75 Typical High $6.61 | Facility | None | $1.82 | $2.75 | $6.61 |
Emblem Health Setting Professional Modifier None Typical Low $1.20 Median $1.95 Typical High $3.24 | Professional | None | $1.20 | $1.95 | $3.24 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.87 Median $0.87 Typical High $0.87 | Facility | None | $0.87 | $0.87 | $0.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.87 Median $1.32 Typical High $1.51 | Professional | None | $0.87 | $1.32 | $1.51 |
MVP Health Care Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
MVP Health Care Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $2.69 | Professional | None | $1.12 | $1.12 | $2.69 |
United Setting Professional Modifier None Typical Low $0.60 Median $1.00 Typical High $1.26 | Professional | None | $0.60 | $1.00 | $1.26 |
Univera Setting Facility Modifier None Typical Low $0.87 Median $0.87 Typical High $1.32 | Facility | None | $0.87 | $0.87 | $1.32 |
Univera Setting Professional Modifier None Typical Low $0.87 Median $1.32 Typical High $1.51 | Professional | None | $0.87 | $1.32 | $1.51 |
4 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 52 · Reduced service Typical Low $0.40 Median $0.40 Typical High $0.85 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.34 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.26 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.17 |
Where New York sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 24th of 51
$1.20
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.