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 $2.51 Median $2.82 Typical High $5.50 | Facility | None | $2.51 | $2.82 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $5.50 | Professional | None | $2.51 | $2.51 | $5.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $3.09 Typical High $10.23 | Professional | None | $2.95 | $3.09 | $10.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.28 Median $0.28 Typical High $0.59 | Professional | RR · Rental | $0.28 | $0.28 | $0.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.19 Median $2.19 Typical High $4.79 | Professional | UE · Used equipment | $2.19 | $2.19 | $4.79 |
CDPHP Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $4.07 | Facility | None | $3.80 | $3.80 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
Emblem Health Setting Facility Modifier None Typical Low $6.03 Median $8.91 Typical High $21.88 | Facility | None | $6.03 | $8.91 | $21.88 |
Emblem Health Setting Professional Modifier None Typical Low $3.89 Median $6.31 Typical High $10.72 | Professional | None | $3.89 | $6.31 | $10.72 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $4.90 | Professional | None | $4.17 | $4.27 | $4.90 |
MVP Health Care Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
MVP Health Care Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $8.71 | Professional | None | $3.63 | $3.63 | $8.71 |
United Setting Professional Modifier None Typical Low $1.95 Median $3.24 Typical High $4.07 | Professional | None | $1.95 | $3.24 | $4.07 |
Univera Setting Facility Modifier None Typical Low $4.17 Median $4.27 Typical High $4.27 | Facility | None | $4.17 | $4.27 | $4.27 |
Univera Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.90 | Professional | None | $4.27 | $4.27 | $4.90 |
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 $0.38 Median $0.38 Typical High $0.83 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.55 |
Where New York sits
The same service costs 3.2 times more in Kansas 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· 32nd of 51
$3.24
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.