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 $1.48 Median $1.66 Typical High $3.24 | Facility | None | $1.48 | $1.66 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $3.24 | Professional | None | $1.48 | $1.48 | $3.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $4.07 Typical High $14.45 | Professional | None | $1.82 | $4.07 | $14.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.17 Median $0.17 Typical High $0.40 | Professional | RR · Rental | $0.17 | $0.17 | $0.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.29 Median $1.29 Typical High $2.57 | Professional | UE · Used equipment | $1.29 | $1.29 | $2.57 |
CDPHP Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $2.04 Typical High $2.19 | Facility | None | $1.82 | $2.04 | $2.19 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Emblem Health Setting Facility Modifier None Typical Low $3.47 Median $5.25 Typical High $12.59 | Facility | None | $3.47 | $5.25 | $12.59 |
Emblem Health Setting Professional Modifier None Typical Low $1.74 Median $3.16 Typical High $6.03 | Professional | None | $1.74 | $3.16 | $6.03 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.04 Median $2.45 Typical High $2.82 | Professional | None | $2.04 | $2.45 | $2.82 |
MVP Health Care Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
MVP Health Care Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $5.01 | Professional | None | $2.09 | $2.09 | $5.01 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.86 Typical High $2.34 | Professional | None | $1.12 | $1.86 | $2.34 |
Univera Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.45 | Facility | None | $2.04 | $2.04 | $2.45 |
Univera Setting Professional Modifier None Typical Low $2.04 Median $2.45 Typical High $2.82 | Professional | None | $2.04 | $2.45 | $2.82 |
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 $0.22 Median $0.22 Typical High $0.48 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.32 |
Highmark BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | AU · Urologic/ostomy supply | $2.75 | $2.75 | $2.75 |
Where New York sits
The same service costs 3.8 times more in Kansas than in Alabama. 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· 29th of 51
$2.09
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.