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 $2.00 Median $2.24 Typical High $4.37 | Facility | None | $2.00 | $2.24 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $4.37 | Professional | None | $2.00 | $2.00 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $7.94 | Professional | None | $2.45 | $2.45 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.48 | Professional | RR · Rental | $0.23 | $0.23 | $0.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.74 Median $1.74 Typical High $3.09 | Professional | UE · Used equipment | $1.74 | $1.74 | $3.09 |
CDPHP Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.82 | Facility | None | $2.57 | $2.57 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.19 | Professional | None | $1.91 | $2.19 | $2.19 |
Emblem Health Setting Facility Modifier None Typical Low $4.68 Median $7.08 Typical High $16.98 | Facility | None | $4.68 | $7.08 | $16.98 |
Emblem Health Setting Professional Modifier None Typical Low $3.09 Median $5.01 Typical High $8.32 | Professional | None | $3.09 | $5.01 | $8.32 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.31 Median $3.39 Typical High $3.89 | Professional | None | $3.31 | $3.39 | $3.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
MVP Health Care Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
MVP Health Care Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $6.92 | Professional | None | $3.02 | $3.02 | $6.92 |
United Setting Professional Modifier None Typical Low $1.55 Median $2.57 Typical High $3.24 | Professional | None | $1.55 | $2.57 | $3.24 |
Univera Setting Facility Modifier None Typical Low $3.31 Median $3.39 Typical High $3.39 | Facility | None | $3.31 | $3.39 | $3.39 |
Univera Setting Professional Modifier None Typical Low $3.31 Median $3.39 Typical High $3.89 | Professional | None | $3.31 | $3.39 | $3.89 |
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 $0.30 Median $0.30 Typical High $0.66 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.44 |
Where New York sits
The same service costs 2.5 times more in Hawaii than in Vermont. 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· 20th 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.