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 $2.24 Median $2.51 Typical High $4.79 | Facility | None | $2.24 | $2.51 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $4.79 | Professional | None | $2.24 | $2.24 | $4.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $6.03 Typical High $8.71 | Professional | None | $2.69 | $6.03 | $8.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.58 | Professional | RR · Rental | $0.26 | $0.26 | $0.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.91 Median $1.91 Typical High $3.47 | Professional | UE · Used equipment | $1.91 | $1.91 | $3.47 |
CDPHP Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.31 | Facility | None | $3.09 | $3.09 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Emblem Health Setting Facility Modifier None Typical Low $5.25 Median $7.76 Typical High $18.62 | Facility | None | $5.25 | $7.76 | $18.62 |
Emblem Health Setting Professional Modifier None Typical Low $3.39 Median $5.75 Typical High $8.91 | Professional | None | $3.39 | $5.75 | $8.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.89 Typical High $4.27 | Professional | None | $3.63 | $3.89 | $4.27 |
Highmark BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
MVP Health Care Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
MVP Health Care Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $7.59 | Professional | None | $3.16 | $3.16 | $7.59 |
United Setting Professional Modifier None Typical Low $1.70 Median $2.82 Typical High $3.55 | Professional | None | $1.70 | $2.82 | $3.55 |
Univera Setting Facility Modifier None Typical Low $3.63 Median $3.89 Typical High $3.89 | Facility | None | $3.63 | $3.89 | $3.89 |
Univera Setting Professional Modifier None Typical Low $3.72 Median $3.89 Typical High $4.27 | Professional | None | $3.72 | $3.89 | $4.27 |
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 $0.33 Median $0.33 Typical High $0.72 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.48 |
Where New York sits
The same service costs 3.2 times more in Kansas than in Missouri. 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
$3.63
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.