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 $1.86 Median $2.19 Typical High $4.07 | Facility | None | $1.86 | $2.19 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $4.07 | Professional | None | $1.86 | $1.86 | $4.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $3.24 Typical High $7.41 | Professional | None | $2.24 | $3.24 | $7.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.21 Median $0.21 Typical High $0.44 | Professional | RR · Rental | $0.21 | $0.21 | $0.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.58 Median $1.58 Typical High $3.16 | Professional | UE · Used equipment | $1.58 | $1.58 | $3.16 |
CDPHP Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Emblem Health Setting Facility Modifier None Typical Low $4.37 Median $6.61 Typical High $15.85 | Facility | None | $4.37 | $6.61 | $15.85 |
Emblem Health Setting Professional Modifier None Typical Low $2.75 Median $3.98 Typical High $7.59 | Professional | None | $2.75 | $3.98 | $7.59 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.24 Typical High $3.55 | Professional | None | $3.02 | $3.24 | $3.55 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
MVP Health Care Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
MVP Health Care Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $6.31 | Professional | None | $2.63 | $2.63 | $6.31 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.34 Typical High $2.95 | Professional | None | $1.41 | $2.34 | $2.95 |
Univera Setting Facility Modifier None Typical Low $3.09 Median $3.24 Typical High $3.39 | Facility | None | $3.09 | $3.24 | $3.39 |
Univera Setting Professional Modifier None Typical Low $3.09 Median $3.24 Typical High $3.55 | Professional | None | $3.09 | $3.24 | $3.55 |
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 $0.28 Median $0.28 Typical High $0.62 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.40 |
Where New York sits
The same service costs 2.3 times more in Hawaii 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· 23rd of 51
$3.02
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.