How much rates vary
Facilitymedian $5 · 10th to 90th $4 to $10Professionalmedian $4 · 10th to 90th $3 to $8
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 $2.82 Median $3.24 Typical High $6.17 | Facility | None | $2.82 | $3.24 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $6.17 | Professional | None | $2.82 | $2.82 | $6.17 |
Ambetter Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $5.75 Typical High $11.22 | Professional | None | $3.39 | $5.75 | $11.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.32 Typical High $0.69 | Professional | RR · Rental | $0.32 | $0.32 | $0.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $2.40 Typical High $5.75 | Professional | UE · Used equipment | $2.40 | $2.40 | $5.75 |
CDPHP Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.17 | Facility | None | $3.89 | $3.89 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Emblem Health Setting Facility Modifier None Typical Low $6.61 Median $10.00 Typical High $23.99 | Facility | None | $6.61 | $10.00 | $23.99 |
Emblem Health Setting Professional Modifier None Typical Low $4.37 Median $6.92 Typical High $11.75 | Professional | None | $4.37 | $6.92 | $11.75 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.07 Median $5.01 Typical High $5.50 | Professional | None | $4.07 | $5.01 | $5.50 |
Highmark BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
MVP Health Care Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
MVP Health Care Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $9.77 | Professional | None | $4.07 | $4.07 | $9.77 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.63 Typical High $4.57 | Professional | None | $2.19 | $3.63 | $4.57 |
Univera Setting Facility Modifier None Typical Low $4.07 Median $5.01 Typical High $5.37 | Facility | None | $4.07 | $5.01 | $5.37 |
Univera Setting Professional Modifier None Typical Low $4.07 Median $5.01 Typical High $5.50 | Professional | None | $4.07 | $5.01 | $5.50 |
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 $1.41 Median $1.41 Typical High $3.09 | Professional | 52 · Reduced service | $1.41 | $1.41 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $1.23 | Professional | 53 · Discontinued | $0.56 | $0.56 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.93 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.62 |
Where New York sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 31st of 51
$4.07
MT $6.92NJ $3.31
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.