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 $1.26 Typical High $2.45 | Facility | None | $1.12 | $1.26 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $2.45 | Professional | None | $1.12 | $1.12 | $2.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $4.57 | Professional | None | $1.58 | $1.58 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.26 | Professional | RR · Rental | $0.13 | $0.13 | $0.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.98 Median $1.38 Typical High $1.38 | Professional | UE · Used equipment | $0.98 | $1.38 | $1.38 |
CDPHP Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Emblem Health Setting Facility Modifier None Typical Low $2.63 Median $3.98 Typical High $9.55 | Facility | None | $2.63 | $3.98 | $9.55 |
Emblem Health Setting Professional Modifier None Typical Low $1.48 Median $2.45 Typical High $4.57 | Professional | None | $1.48 | $2.45 | $4.57 |
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 $1.86 Median $1.91 Typical High $2.14 | Professional | None | $1.86 | $1.91 | $2.14 |
Highmark BCBS Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
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 $1.62 Median $1.62 Typical High $3.89 | Professional | None | $1.62 | $1.62 | $3.89 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.45 Typical High $1.82 | Professional | None | $0.85 | $1.45 | $1.82 |
Univera Setting Facility Modifier None Typical Low $1.86 Median $1.91 Typical High $1.91 | Facility | None | $1.86 | $1.91 | $1.91 |
Univera Setting Professional Modifier None Typical Low $1.86 Median $1.91 Typical High $2.14 | Professional | None | $1.86 | $1.91 | $2.14 |
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 $1.23 | Professional | 52 · Reduced service | $0.56 | $0.56 | $1.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.49 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.37 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.25 |
Where New York sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 25th of 51
$1.74
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.