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 $0.85 Median $0.98 Typical High $1.86 | Facility | None | $0.85 | $0.98 | $1.86 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.86 | Professional | None | $0.85 | $0.85 | $1.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $3.55 | Professional | None | $1.82 | $1.82 | $3.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.10 Median $0.10 Typical High $0.20 | Professional | RR · Rental | $0.10 | $0.10 | $0.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.74 Median $1.05 Typical High $1.05 | Professional | UE · Used equipment | $0.74 | $1.05 | $1.05 |
CDPHP Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.29 | Facility | None | $1.20 | $1.20 | $1.29 |
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 $2.04 Median $3.02 Typical High $7.24 | Facility | None | $2.04 | $3.02 | $7.24 |
Emblem Health Setting Professional Modifier None Typical Low $1.32 Median $2.04 Typical High $3.47 | Professional | None | $1.32 | $2.04 | $3.47 |
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 $1.41 Median $1.51 Typical High $1.66 | Professional | None | $1.41 | $1.51 | $1.66 |
MVP Health Care Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
MVP Health Care Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $2.95 | Professional | None | $1.32 | $1.32 | $2.95 |
United Setting Professional Modifier None Typical Low $0.66 Median $1.10 Typical High $1.38 | Professional | None | $0.66 | $1.10 | $1.38 |
Univera Setting Facility Modifier None Typical Low $1.45 Median $1.51 Typical High $1.55 | Facility | None | $1.45 | $1.51 | $1.55 |
Univera Setting Professional Modifier None Typical Low $1.45 Median $1.51 Typical High $1.66 | Professional | None | $1.45 | $1.51 | $1.66 |
2 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 $0.13 Median $0.13 Typical High $0.28 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.19 |
Where New York sits
The same service costs 2.1 times more in Kansas than in Kentucky. 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
$1.45
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.