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 $5.01 Median $5.62 Typical High $10.96 | Facility | None | $5.01 | $5.62 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $10.96 | Professional | None | $5.01 | $5.01 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $6.17 Typical High $19.95 | Professional | None | $5.75 | $6.17 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.58 Median $0.58 Typical High $1.26 | Professional | RR · Rental | $0.58 | $0.58 | $1.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.37 Median $4.37 Typical High $7.76 | Professional | UE · Used equipment | $4.37 | $4.37 | $7.76 |
CDPHP Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $8.13 | Facility | None | $7.59 | $7.59 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Emblem Health Setting Facility Modifier None Typical Low $11.75 Median $17.78 Typical High $42.66 | Facility | None | $11.75 | $17.78 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $2.40 Median $10.72 Typical High $20.42 | Professional | None | $2.40 | $10.72 | $20.42 |
Excellus BCBS Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $9.55 | Professional | None | $8.32 | $8.71 | $9.55 |
MVP Health Care Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
MVP Health Care Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $17.38 | Professional | None | $7.08 | $7.08 | $17.38 |
United Setting Professional Modifier None Typical Low $3.80 Median $6.31 Typical High $8.13 | Professional | None | $3.80 | $6.31 | $8.13 |
Univera Setting Facility Modifier None Typical Low $8.32 Median $8.71 Typical High $8.71 | Facility | None | $8.32 | $8.71 | $8.71 |
Univera Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $9.55 | Professional | None | $8.32 | $8.71 | $9.55 |
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 $2.51 Median $2.51 Typical High $5.50 | Professional | 52 · Reduced service | $2.51 | $2.51 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.00 Typical High $2.19 | Professional | 53 · Discontinued | $1.00 | $1.00 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $1.62 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.50 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.50 | $0.50 | $1.10 |
Where New York sits
The same service costs 2.1 times more in Idaho 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· 30th of 51
$7.08
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.