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 $3.63 Median $4.07 Typical High $7.94 | Facility | None | $3.63 | $4.07 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $7.94 | Professional | None | $3.63 | $3.63 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $4.90 Typical High $14.45 | Professional | None | $4.47 | $4.90 | $14.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.42 Typical High $0.91 | Professional | RR · Rental | $0.42 | $0.42 | $0.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.16 Median $3.16 Typical High $5.62 | Professional | UE · Used equipment | $3.16 | $3.16 | $5.62 |
CDPHP Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Emblem Health Setting Facility Modifier None Typical Low $8.51 Median $12.88 Typical High $30.90 | Facility | None | $8.51 | $12.88 | $30.90 |
Emblem Health Setting Professional Modifier None Typical Low $5.01 Median $7.94 Typical High $14.79 | Professional | None | $5.01 | $7.94 | $14.79 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $6.92 | Professional | None | $4.57 | $6.03 | $6.92 |
Highmark BCBS Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
MVP Health Care Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
MVP Health Care Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $12.59 | Professional | None | $5.13 | $5.13 | $12.59 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.57 Typical High $5.89 | Professional | None | $2.75 | $4.57 | $5.89 |
Univera Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $6.03 | Facility | None | $4.57 | $4.57 | $6.03 |
Univera Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $6.92 | Professional | None | $4.57 | $6.03 | $6.92 |
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 $0.55 Median $0.55 Typical High $1.20 | Professional | 55 · Aftercare only | $0.55 | $0.55 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.79 |
Where New York sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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· 36th 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.