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 $1.10 Median $1.23 Typical High $2.40 | Facility | None | $1.10 | $1.23 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $2.40 | Professional | None | $1.10 | $1.10 | $2.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $4.37 | Professional | None | $1.32 | $1.32 | $4.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.26 | Professional | RR · Rental | $0.13 | $0.13 | $0.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.93 Median $0.93 Typical High $1.58 | Professional | UE · Used equipment | $0.93 | $0.93 | $1.58 |
CDPHP Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.62 | Facility | None | $1.51 | $1.51 | $1.62 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Emblem Health Setting Facility Modifier None Typical Low $2.57 Median $3.80 Typical High $9.33 | Facility | None | $2.57 | $3.80 | $9.33 |
Emblem Health Setting Professional Modifier None Typical Low $1.29 Median $2.34 Typical High $4.47 | Professional | None | $1.29 | $2.34 | $4.47 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.70 Median $1.82 Typical High $2.09 | Professional | None | $1.70 | $1.82 | $2.09 |
MVP Health Care Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
MVP Health Care Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $3.72 | Professional | None | $1.15 | $1.15 | $3.72 |
United Setting Professional Modifier None Typical Low $0.83 Median $1.38 Typical High $1.78 | Professional | None | $0.83 | $1.38 | $1.78 |
Univera Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.82 | Facility | None | $1.70 | $1.70 | $1.82 |
Univera Setting Professional Modifier None Typical Low $1.70 Median $1.82 Typical High $2.09 | Professional | None | $1.70 | $1.82 | $2.09 |
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 $0.16 Median $0.16 Typical High $0.36 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.24 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | KX · Policy requirements met | $1.62 | $1.62 | $1.62 |
Where New York sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 27th of 51
$1.58
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.