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 $9.12 Median $10.23 Typical High $19.95 | Facility | None | $9.12 | $10.23 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $19.95 | Professional | None | $9.12 | $9.12 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $11.22 Typical High $36.31 | Professional | None | $10.47 | $11.22 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.05 Median $1.05 Typical High $2.29 | Professional | RR · Rental | $1.05 | $1.05 | $2.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.94 Median $7.94 Typical High $14.13 | Professional | UE · Used equipment | $7.94 | $7.94 | $14.13 |
CDPHP Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $14.79 | Facility | None | $13.80 | $13.80 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $11.75 | Professional | None | $8.71 | $11.75 | $11.75 |
Emblem Health Setting Facility Modifier None Typical Low $21.38 Median $32.36 Typical High $77.62 | Facility | None | $21.38 | $32.36 | $77.62 |
Emblem Health Setting Professional Modifier None Typical Low $13.80 Median $22.39 Typical High $38.02 | Professional | None | $13.80 | $22.39 | $38.02 |
Excellus BCBS Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Excellus BCBS Setting Professional Modifier None Typical Low $15.14 Median $15.85 Typical High $17.38 | Professional | None | $15.14 | $15.85 | $17.38 |
MVP Health Care Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
MVP Health Care Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $30.90 | Professional | None | $12.88 | $12.88 | $30.90 |
United Setting Professional Modifier None Typical Low $6.92 Median $11.48 Typical High $14.79 | Professional | None | $6.92 | $11.48 | $14.79 |
Univera Setting Facility Modifier None Typical Low $15.14 Median $15.85 Typical High $15.85 | Facility | None | $15.14 | $15.85 | $15.85 |
Univera Setting Professional Modifier None Typical Low $15.14 Median $15.85 Typical High $17.38 | Professional | None | $15.14 | $15.85 | $17.38 |
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 $1.38 Median $1.38 Typical High $2.95 | Professional | 55 · Aftercare only | $1.38 | $1.38 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.91 Typical High $2.00 | Professional | 56 · Pre-op care only | $0.91 | $0.91 | $2.00 |
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· 38th of 51
$11.75
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.