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 $1.70 Median $1.91 Typical High $3.72 | Facility | None | $1.70 | $1.91 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $3.72 | Professional | None | $1.70 | $1.70 | $3.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $3.39 Typical High $6.76 | Professional | None | $2.04 | $3.39 | $6.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.20 Median $0.20 Typical High $0.43 | Professional | RR · Rental | $0.20 | $0.20 | $0.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.45 Median $1.45 Typical High $2.63 | Professional | UE · Used equipment | $1.45 | $1.45 | $2.63 |
CDPHP Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Emblem Health Setting Facility Modifier None Typical Low $3.98 Median $6.03 Typical High $14.45 | Facility | None | $3.98 | $6.03 | $14.45 |
Emblem Health Setting Professional Modifier None Typical Low $2.57 Median $3.63 Typical High $6.92 | Professional | None | $2.57 | $3.63 | $6.92 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Facility | None | $2.75 | $2.75 | $2.75 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.75 Median $2.82 Typical High $3.24 | Professional | None | $2.75 | $2.82 | $3.24 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
MVP Health Care Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
MVP Health Care Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $5.75 | Professional | None | $2.40 | $2.40 | $5.75 |
United Setting Professional Modifier None Typical Low $1.29 Median $2.14 Typical High $2.69 | Professional | None | $1.29 | $2.14 | $2.69 |
Univera Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $2.82 | Facility | None | $2.75 | $2.75 | $2.82 |
Univera Setting Professional Modifier None Typical Low $2.75 Median $2.82 Typical High $3.24 | Professional | None | $2.75 | $2.82 | $3.24 |
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 $0.85 Median $0.85 Typical High $1.82 | Professional | 52 · Reduced service | $0.85 | $0.85 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.34 Typical High $0.74 | Professional | 53 · Discontinued | $0.34 | $0.34 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.55 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.37 |
Where New York sits
The same service costs 2.2 times more in Kansas 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· 23rd of 51
$2.75
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.