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 $2.29 Median $2.57 Typical High $5.01 | Facility | None | $2.29 | $2.57 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $5.01 | Professional | None | $2.29 | $2.29 | $5.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $6.17 Typical High $9.12 | Professional | None | $2.63 | $6.17 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.56 | Professional | RR · Rental | $0.26 | $0.26 | $0.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.95 Median $1.95 Typical High $4.27 | Professional | UE · Used equipment | $1.95 | $1.95 | $4.27 |
CDPHP Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.80 | Facility | None | $3.55 | $3.55 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Emblem Health Setting Facility Modifier None Typical Low $5.37 Median $7.94 Typical High $19.50 | Facility | None | $5.37 | $7.94 | $19.50 |
Emblem Health Setting Professional Modifier None Typical Low $3.39 Median $4.90 Typical High $9.33 | Professional | None | $3.39 | $4.90 | $9.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.80 Median $3.98 Typical High $4.37 | Professional | None | $3.80 | $3.98 | $4.37 |
MVP Health Care Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
MVP Health Care Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $7.76 | Professional | None | $3.24 | $3.24 | $7.76 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.88 Typical High $3.63 | Professional | None | $1.74 | $2.88 | $3.63 |
Univera Setting Facility Modifier None Typical Low $3.80 Median $3.98 Typical High $3.98 | Facility | None | $3.80 | $3.98 | $3.98 |
Univera Setting Professional Modifier None Typical Low $3.80 Median $3.98 Typical High $4.37 | Professional | None | $3.80 | $3.98 | $4.37 |
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 $1.12 Median $1.12 Typical High $2.51 | Professional | 52 · Reduced service | $1.12 | $1.12 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.46 Typical High $1.00 | Professional | 53 · Discontinued | $0.46 | $0.46 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.34 Typical High $0.76 | Professional | 55 · Aftercare only | $0.34 | $0.34 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.50 |
Where New York sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 22nd of 51
$3.80
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.