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 $1.12 Median $1.23 Typical High $2.40 | Facility | None | $1.12 | $1.23 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $2.40 | Professional | None | $1.12 | $1.12 | $2.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.82 Typical High $4.37 | Professional | None | $1.26 | $1.82 | $4.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.25 | Professional | RR · Rental | $0.13 | $0.13 | $0.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $0.95 Typical High $2.14 | Professional | UE · Used equipment | $0.95 | $0.95 | $2.14 |
CDPHP Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.82 | Facility | None | $1.70 | $1.70 | $1.82 |
Cigna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
Emblem Health Setting Facility Modifier None Typical Low $2.57 Median $3.89 Typical High $9.33 | Facility | None | $2.57 | $3.89 | $9.33 |
Emblem Health Setting Professional Modifier None Typical Low $1.62 Median $2.34 Typical High $4.47 | Professional | None | $1.62 | $2.34 | $4.47 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.91 Typical High $2.09 | Professional | None | $1.82 | $1.91 | $2.09 |
MVP Health Care Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
MVP Health Care Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $3.80 | Professional | None | $1.58 | $1.58 | $3.80 |
United Setting Professional Modifier None Typical Low $0.83 Median $1.41 Typical High $1.78 | Professional | None | $0.83 | $1.41 | $1.78 |
Univera Setting Facility Modifier None Typical Low $1.82 Median $1.91 Typical High $1.91 | Facility | None | $1.82 | $1.91 | $1.91 |
Univera Setting Professional Modifier None Typical Low $1.82 Median $1.91 Typical High $2.09 | Professional | None | $1.82 | $1.91 | $2.09 |
4 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 52 · Reduced service Typical Low $0.56 Median $0.56 Typical High $1.20 | Professional | 52 · Reduced service | $0.56 | $0.56 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.48 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.36 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.24 |
Where New York sits
The same service costs 2.3 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· 21st of 51
$1.82
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.