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 $5.13 Median $5.75 Typical High $11.22 | Facility | None | $5.13 | $5.75 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $11.22 | Professional | None | $5.13 | $5.13 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $9.12 Typical High $20.42 | Professional | None | $6.31 | $9.12 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.60 Median $0.60 Typical High $1.29 | Professional | RR · Rental | $0.60 | $0.60 | $1.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $4.47 Typical High $8.51 | Professional | UE · Used equipment | $4.47 | $4.47 | $8.51 |
CDPHP Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Emblem Health Setting Facility Modifier None Typical Low $12.02 Median $18.20 Typical High $43.65 | Facility | None | $12.02 | $18.20 | $43.65 |
Emblem Health Setting Professional Modifier None Typical Low $7.94 Median $11.22 Typical High $20.89 | Professional | None | $7.94 | $11.22 | $20.89 |
Excellus BCBS Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.51 Median $9.12 Typical High $10.00 | Professional | None | $8.51 | $9.12 | $10.00 |
Highmark BCBS Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
MVP Health Care Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
MVP Health Care Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $17.78 | Professional | None | $7.41 | $7.41 | $17.78 |
United Setting Professional Modifier None Typical Low $3.98 Median $6.61 Typical High $8.32 | Professional | None | $3.98 | $6.61 | $8.32 |
Univera Setting Facility Modifier None Typical Low $8.51 Median $9.12 Typical High $9.12 | Facility | None | $8.51 | $9.12 | $9.12 |
Univera Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $10.00 | Professional | None | $8.71 | $9.12 | $10.00 |
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 $2.57 Median $2.57 Typical High $5.62 | Professional | 52 · Reduced service | $2.57 | $2.57 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.05 Typical High $2.24 | Professional | 53 · Discontinued | $1.05 | $1.05 | $2.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $1.70 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $1.12 |
Where New York sits
The same service costs 2.1 times more in Hawaii 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
$8.51
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.