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 $0.95 Median $0.98 Typical High $2.09 | Facility | None | $0.95 | $0.98 | $2.09 |
Aetna Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $2.09 | Professional | None | $0.98 | $0.98 | $2.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.95 Typical High $3.89 | Professional | None | $1.17 | $1.95 | $3.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.11 Median $0.11 Typical High $0.18 | Professional | RR · Rental | $0.11 | $0.11 | $0.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.83 Median $1.17 Typical High $1.95 | Professional | UE · Used equipment | $0.83 | $1.17 | $1.95 |
CDPHP Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $1.45 | Facility | None | $0.72 | $1.35 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Emblem Health Setting Facility Modifier None Typical Low $2.29 Median $3.39 Typical High $8.13 | Facility | None | $2.29 | $3.39 | $8.13 |
Emblem Health Setting Professional Modifier None Typical Low $1.48 Median $2.09 Typical High $3.89 | Professional | None | $1.48 | $2.09 | $3.89 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Facility | None | $0.43 | $0.43 | $0.43 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.43 Median $1.62 Typical High $1.86 | Professional | None | $0.43 | $1.62 | $1.86 |
MVP Health Care Setting Facility Modifier None Typical Low $0.95 Median $0.95 Typical High $0.95 | Facility | None | $0.95 | $0.95 | $0.95 |
MVP Health Care Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $3.31 | Professional | None | $1.12 | $1.12 | $3.31 |
United Setting Professional Modifier None Typical Low $0.74 Median $1.23 Typical High $1.55 | Professional | None | $0.74 | $1.23 | $1.55 |
Univera Setting Facility Modifier None Typical Low $0.43 Median $0.43 Typical High $1.62 | Facility | None | $0.43 | $0.43 | $1.62 |
Univera Setting Professional Modifier None Typical Low $0.43 Median $1.62 Typical High $1.86 | Professional | None | $0.43 | $1.62 | $1.86 |
3 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 $0.15 Median $0.15 Typical High $0.32 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.21 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | KX · Policy requirements met | $1.45 | $1.45 | $1.45 |
Where New York sits
The same service costs 5.8 times more in Hawaii than in Rhode Island. 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· 29th of 51
$1.35
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.