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 $3.47 Median $3.89 Typical High $7.59 | Facility | None | $3.47 | $3.89 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $7.59 | Professional | None | $3.47 | $3.47 | $7.59 |
Ambetter Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.57 Typical High $13.80 | Professional | None | $4.27 | $4.57 | $13.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.40 Median $0.40 Typical High $0.87 | Professional | RR · Rental | $0.40 | $0.40 | $0.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.02 Typical High $6.03 | Professional | UE · Used equipment | $3.02 | $3.02 | $6.03 |
CDPHP Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Emblem Health Setting Facility Modifier None Typical Low $8.13 Median $12.30 Typical High $29.51 | Facility | None | $8.13 | $12.30 | $29.51 |
Emblem Health Setting Professional Modifier None Typical Low $4.47 Median $7.59 Typical High $14.13 | Professional | None | $4.47 | $7.59 | $14.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $6.61 | Professional | None | $5.75 | $6.03 | $6.61 |
Highmark BCBS Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
MVP Health Care Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
MVP Health Care Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $12.02 | Professional | None | $4.90 | $4.90 | $12.02 |
United Setting Professional Modifier None Typical Low $2.63 Median $4.37 Typical High $5.62 | Professional | None | $2.63 | $4.37 | $5.62 |
Univera Setting Facility Modifier None Typical Low $5.75 Median $6.03 Typical High $6.03 | Facility | None | $5.75 | $6.03 | $6.03 |
Univera Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $6.61 | Professional | None | $5.75 | $6.03 | $6.61 |
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 $0.52 Median $0.52 Typical High $1.12 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.76 |
Where New York sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 31st of 51
$4.90
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.