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 $5.89 Median $6.61 Typical High $12.59 | Facility | None | $5.89 | $6.61 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $12.59 | Professional | None | $5.89 | $5.89 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $7.08 Typical High $23.44 | Professional | None | $6.76 | $7.08 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $0.68 Typical High $1.51 | Professional | RR · Rental | $0.68 | $0.68 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.01 Median $5.01 Typical High $10.00 | Professional | UE · Used equipment | $5.01 | $5.01 | $10.00 |
CDPHP Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.71 | Facility | None | $8.13 | $8.13 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Emblem Health Setting Facility Modifier None Typical Low $13.80 Median $20.42 Typical High $48.98 | Facility | None | $13.80 | $20.42 | $48.98 |
Emblem Health Setting Professional Modifier None Typical Low $8.91 Median $14.45 Typical High $23.99 | Professional | None | $8.91 | $14.45 | $23.99 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.55 Median $10.23 Typical High $11.22 | Professional | None | $9.55 | $10.23 | $11.22 |
MVP Health Care Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
MVP Health Care Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $19.95 | Professional | None | $8.32 | $8.32 | $19.95 |
United Setting Professional Modifier None Typical Low $4.47 Median $7.41 Typical High $9.33 | Professional | None | $4.47 | $7.41 | $9.33 |
Univera Setting Facility Modifier None Typical Low $9.55 Median $10.23 Typical High $10.23 | Facility | None | $9.55 | $10.23 | $10.23 |
Univera Setting Professional Modifier None Typical Low $9.77 Median $10.23 Typical High $11.22 | Professional | None | $9.77 | $10.23 | $11.22 |
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 $0.87 Median $0.87 Typical High $1.91 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $1.26 |
Where New York sits
The same service costs 5.4 times more in Kansas 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· 32nd of 51
$8.13
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.