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 $1.95 Median $2.19 Typical High $4.17 | Facility | None | $1.95 | $2.19 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $4.17 | Professional | None | $1.95 | $1.95 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $7.76 | Professional | None | $2.24 | $2.24 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.45 | Professional | RR · Rental | $0.23 | $0.23 | $0.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.70 Median $1.70 Typical High $3.72 | Professional | UE · Used equipment | $1.70 | $1.70 | $3.72 |
CDPHP Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Emblem Health Setting Facility Modifier None Typical Low $4.57 Median $6.76 Typical High $16.22 | Facility | None | $4.57 | $6.76 | $16.22 |
Emblem Health Setting Professional Modifier None Typical Low $2.95 Median $4.79 Typical High $7.94 | Professional | None | $2.95 | $4.79 | $7.94 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.51 Median $2.57 Typical High $3.72 | Professional | None | $1.51 | $2.57 | $3.72 |
MVP Health Care Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
MVP Health Care Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $6.61 | Professional | None | $2.95 | $2.95 | $6.61 |
United Setting Professional Modifier None Typical Low $1.48 Median $2.75 Typical High $3.47 | Professional | None | $1.48 | $2.75 | $3.47 |
Univera Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $2.57 | Facility | None | $1.51 | $1.51 | $2.57 |
Univera Setting Professional Modifier None Typical Low $1.51 Median $2.57 Typical High $3.72 | Professional | None | $1.51 | $2.57 | $3.72 |
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 $0.98 Median $0.98 Typical High $2.09 | Professional | 52 · Reduced service | $0.98 | $0.98 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.39 Typical High $0.83 | Professional | 53 · Discontinued | $0.39 | $0.39 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.63 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.42 |
Where New York sits
The same service costs 2.1 times more in Montana 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· 32nd of 51
$2.57
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.