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 $0.31 Median $0.46 Typical High $0.71 | Facility | None | $0.31 | $0.46 | $0.71 |
Aetna Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $0.71 | Professional | None | $0.46 | $0.46 | $0.71 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.63 | Professional | None | $0.30 | $0.30 | $0.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.22 Median $0.30 Typical High $0.30 | Professional | UE · Used equipment | $0.22 | $0.30 | $0.30 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Facility | None | $0.89 | $0.89 | $0.89 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Emblem Health Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Facility | None | $0.40 | $0.40 | $0.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.40 Median $0.56 Typical High $0.62 | Professional | None | $0.40 | $0.56 | $0.62 |
MVP Health Care Setting Facility Modifier None Typical Low $0.87 Median $0.87 Typical High $0.87 | Facility | None | $0.87 | $0.87 | $0.87 |
MVP Health Care Setting Professional Modifier None Typical Low $0.72 Median $0.93 Typical High $1.45 | Professional | None | $0.72 | $0.93 | $1.45 |
United Setting Professional Modifier None Typical Low $0.31 Median $0.51 Typical High $0.65 | Professional | None | $0.31 | $0.51 | $0.65 |
Univera Setting Facility Modifier None Typical Low $0.40 Median $0.40 Typical High $1.38 | Facility | None | $0.40 | $0.40 | $1.38 |
Univera Setting Professional Modifier None Typical Low $0.40 Median $0.56 Typical High $0.62 | Professional | None | $0.40 | $0.56 | $0.62 |
3 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 $0.07 Median $0.07 Typical High $0.11 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.05 Typical High $0.08 | Professional | RR · Rental | $0.04 | $0.05 | $0.08 |
Where New York sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 43rd of 51
$0.46
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.