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 $0.74 Median $0.95 Typical High $1.58 | Facility | None | $0.74 | $0.95 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $1.58 | Professional | None | $0.74 | $0.74 | $1.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.74 Median $2.00 Typical High $7.24 | Professional | None | $0.74 | $2.00 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.54 Median $0.74 Typical High $0.74 | Professional | UE · Used equipment | $0.54 | $0.74 | $0.74 |
CDPHP Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Cigna Setting Facility Modifier None Typical Low $1.15 Median $2.63 Typical High $2.63 | Facility | None | $1.15 | $2.63 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Emblem Health Setting Facility Modifier None Typical Low $1.74 Median $2.57 Typical High $6.31 | Facility | None | $1.74 | $2.57 | $6.31 |
Emblem Health Setting Professional Modifier None Typical Low $0.85 Median $1.91 Typical High $3.16 | Professional | None | $0.85 | $1.91 | $3.16 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Facility | None | $1.29 | $1.29 | $1.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.98 Median $1.29 Typical High $1.41 | Professional | None | $0.98 | $1.29 | $1.41 |
MVP Health Care Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Facility | None | $2.75 | $2.75 | $2.75 |
MVP Health Care Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $2.51 | Professional | None | $1.12 | $1.12 | $2.51 |
United Setting Professional Modifier None Typical Low $0.56 Median $1.05 Typical High $1.26 | Professional | None | $0.56 | $1.05 | $1.26 |
Univera Setting Facility Modifier None Typical Low $1.00 Median $1.29 Typical High $1.29 | Facility | None | $1.00 | $1.29 | $1.29 |
Univera Setting Professional Modifier None Typical Low $0.98 Median $1.29 Typical High $1.41 | Professional | None | $0.98 | $1.29 | $1.41 |
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 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.24 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.16 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.14 Typical High $0.25 | Professional | RR · Rental | $0.09 | $0.14 | $0.25 |
Fidelis Setting Professional Modifier KX · Policy requirements met Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | KX · Policy requirements met | $0.85 | $0.85 | $0.85 |
Where New York sits
The same service costs 3.1 times more in Hawaii than in Utah. 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· 26th of 51
$1.12
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.