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 $5.89 Median $6.76 Typical High $12.59 | Facility | None | $5.89 | $6.76 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $12.59 | Professional | None | $5.89 | $5.89 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $23.44 | Professional | None | $6.92 | $6.92 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.66 Median $0.66 Typical High $1.45 | Professional | RR · Rental | $0.66 | $0.66 | $1.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.90 Median $4.90 Typical High $9.33 | Professional | UE · Used equipment | $4.90 | $4.90 | $9.33 |
CDPHP Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.71 | Facility | None | $8.13 | $8.13 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Emblem Health Setting Facility Modifier None Typical Low $13.80 Median $20.42 Typical High $48.98 | Facility | None | $13.80 | $20.42 | $48.98 |
Emblem Health Setting Professional Modifier None Typical Low $8.91 Median $14.45 Typical High $23.99 | Professional | None | $8.91 | $14.45 | $23.99 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.32 Median $10.47 Typical High $11.22 | Professional | None | $8.32 | $10.47 | $11.22 |
Highmark BCBS Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
MVP Health Care Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
MVP Health Care Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $19.95 | Professional | None | $8.32 | $8.32 | $19.95 |
United Setting Professional Modifier None Typical Low $4.47 Median $7.41 Typical High $9.33 | Professional | None | $4.47 | $7.41 | $9.33 |
Univera Setting Facility Modifier None Typical Low $8.32 Median $10.47 Typical High $10.96 | Facility | None | $8.32 | $10.47 | $10.96 |
Univera Setting Professional Modifier None Typical Low $8.32 Median $10.47 Typical High $11.22 | Professional | None | $8.32 | $10.47 | $11.22 |
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 $2.95 Median $2.95 Typical High $6.31 | Professional | 52 · Reduced service | $2.95 | $2.95 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.17 Typical High $2.51 | Professional | 53 · Discontinued | $1.17 | $1.17 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $1.91 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $1.26 |
Where New York sits
The same service costs 2.2 times more in Hawaii than in Maine. 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
$8.32
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.