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 $0.07 Median $0.08 Typical High $0.15 | Facility | None | $0.07 | $0.08 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.07 Median $0.07 Typical High $0.15 | Professional | None | $0.07 | $0.07 | $0.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.08 Median $0.21 Typical High $0.34 | Professional | None | $0.08 | $0.21 | $0.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.06 Median $0.08 Typical High $0.19 | Professional | UE · Used equipment | $0.06 | $0.08 | $0.19 |
Cigna Setting Facility Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Facility | None | $0.09 | $0.09 | $0.09 |
Cigna Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | None | $0.08 | $0.08 | $0.08 |
Emblem Health Setting Facility Modifier None Typical Low $0.15 Median $0.23 Typical High $0.54 | Facility | None | $0.15 | $0.23 | $0.54 |
Emblem Health Setting Professional Modifier None Typical Low $0.10 Median $0.16 Typical High $0.27 | Professional | None | $0.10 | $0.16 | $0.27 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Facility | None | $0.13 | $0.13 | $0.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | None | $0.12 | $0.12 | $0.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
MVP Health Care Setting Facility Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Facility | None | $0.30 | $0.30 | $0.30 |
MVP Health Care Setting Professional Modifier None Typical Low $0.10 Median $0.10 Typical High $0.22 | Professional | None | $0.10 | $0.10 | $0.22 |
United Setting Professional Modifier None Typical Low $0.05 Median $0.09 Typical High $0.11 | Professional | None | $0.05 | $0.09 | $0.11 |
Univera Setting Facility Modifier None Typical Low $0.12 Median $0.13 Typical High $0.14 | Facility | None | $0.12 | $0.13 | $0.14 |
Univera Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | None | $0.12 | $0.12 | $0.13 |
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 $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.02 Median $0.02 Typical High $0.08 | Professional | RR · Rental | $0.02 | $0.02 | $0.08 |
Where New York sits
The same service costs 2.0 times more in Idaho than in Ohio. 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
$0.10
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.