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 $2.82 Median $3.16 Typical High $6.17 | Facility | None | $2.82 | $3.16 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $6.17 | Professional | None | $2.82 | $2.82 | $6.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $11.22 | Professional | None | $3.24 | $3.24 | $11.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.32 Typical High $0.69 | Professional | RR · Rental | $0.32 | $0.32 | $0.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $2.40 Typical High $5.25 | Professional | UE · Used equipment | $2.40 | $2.40 | $5.25 |
CDPHP Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.17 | Facility | None | $3.89 | $3.89 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Emblem Health Setting Facility Modifier None Typical Low $6.61 Median $10.00 Typical High $23.99 | Facility | None | $6.61 | $10.00 | $23.99 |
Emblem Health Setting Professional Modifier None Typical Low $4.27 Median $6.17 Typical High $11.75 | Professional | None | $4.27 | $6.17 | $11.75 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.55 Median $4.68 Typical High $5.37 | Professional | None | $3.55 | $4.68 | $5.37 |
MVP Health Care Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
MVP Health Care Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $9.55 | Professional | None | $3.98 | $3.98 | $9.55 |
United Setting Professional Modifier None Typical Low $2.14 Median $3.55 Typical High $4.47 | Professional | None | $2.14 | $3.55 | $4.47 |
Univera Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $4.68 | Facility | None | $3.55 | $3.55 | $4.68 |
Univera Setting Professional Modifier None Typical Low $3.55 Median $4.68 Typical High $5.37 | Professional | None | $3.55 | $4.68 | $5.37 |
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 $0.42 Median $0.42 Typical High $0.91 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.62 |
Where New York sits
The same service costs 2.6 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· 28th of 51
$3.98
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.