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 $10.47 Median $11.75 Typical High $22.91 | Facility | None | $10.47 | $11.75 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $22.91 | Professional | None | $10.47 | $10.47 | $22.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $41.69 | Professional | None | $12.02 | $12.88 | $41.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.20 Median $1.20 Typical High $2.63 | Professional | RR · Rental | $1.20 | $1.20 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.12 Median $9.12 Typical High $17.78 | Professional | UE · Used equipment | $9.12 | $9.12 | $17.78 |
CDPHP Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $16.98 | Facility | None | $15.85 | $15.85 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $13.49 | Professional | None | $10.00 | $13.49 | $13.49 |
Emblem Health Setting Facility Modifier None Typical Low $24.55 Median $36.31 Typical High $89.13 | Facility | None | $24.55 | $36.31 | $89.13 |
Emblem Health Setting Professional Modifier None Typical Low $15.85 Median $25.70 Typical High $43.65 | Professional | None | $15.85 | $25.70 | $43.65 |
Excellus BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $19.95 | Professional | None | $17.38 | $18.20 | $19.95 |
MVP Health Care Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
MVP Health Care Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $35.48 | Professional | None | $14.79 | $14.79 | $35.48 |
United Setting Professional Modifier None Typical Low $7.94 Median $13.18 Typical High $16.60 | Professional | None | $7.94 | $13.18 | $16.60 |
Univera Setting Facility Modifier None Typical Low $17.38 Median $18.20 Typical High $18.20 | Facility | None | $17.38 | $18.20 | $18.20 |
Univera Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $19.95 | Professional | None | $17.38 | $18.20 | $19.95 |
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 $1.58 Median $1.58 Typical High $3.39 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $2.29 |
Where New York sits
The same service costs 2.3 times more in Hawaii than in Connecticut. 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· 36th of 51
$13.49
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.