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 $5.37 Median $6.03 Typical High $11.48 | Facility | None | $5.37 | $6.03 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $11.48 | Professional | None | $5.37 | $5.37 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.46 Median $8.71 Typical High $20.89 | Professional | None | $6.46 | $8.71 | $20.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.62 Median $0.62 Typical High $1.32 | Professional | RR · Rental | $0.62 | $0.62 | $1.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.57 Median $4.57 Typical High $8.32 | Professional | UE · Used equipment | $4.57 | $4.57 | $8.32 |
CDPHP Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.94 | Facility | None | $7.41 | $7.41 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
Emblem Health Setting Facility Modifier None Typical Low $12.59 Median $18.62 Typical High $44.67 | Facility | None | $12.59 | $18.62 | $44.67 |
Emblem Health Setting Professional Modifier None Typical Low $7.41 Median $11.48 Typical High $21.38 | Professional | None | $7.41 | $11.48 | $21.38 |
Excellus BCBS Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.71 Median $8.91 Typical High $10.23 | Professional | None | $8.71 | $8.91 | $10.23 |
Highmark BCBS Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
MVP Health Care Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
MVP Health Care Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $18.20 | Professional | None | $7.59 | $7.59 | $18.20 |
United Setting Professional Modifier None Typical Low $4.07 Median $6.76 Typical High $8.51 | Professional | None | $4.07 | $6.76 | $8.51 |
Univera Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.91 | Facility | None | $8.71 | $8.71 | $8.91 |
Univera Setting Professional Modifier None Typical Low $8.71 Median $8.91 Typical High $10.23 | Professional | None | $8.71 | $8.91 | $10.23 |
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 $0.79 Median $0.79 Typical High $1.74 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $1.15 |
Where New York sits
The same service costs 2.0 times more in Montana than in Florida. 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· 23rd of 51
$8.71
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.