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 $6.17 Median $8.13 Typical High $13.49 | Facility | None | $6.17 | $8.13 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $13.49 | Professional | None | $6.17 | $6.17 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $24.55 | Professional | None | $7.59 | $7.59 | $24.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.71 Median $0.71 Typical High $1.55 | Professional | RR · Rental | $0.71 | $0.71 | $1.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.37 Median $5.37 Typical High $9.55 | Professional | UE · Used equipment | $5.37 | $5.37 | $9.55 |
CDPHP Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.72 | Facility | None | $10.00 | $10.00 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Emblem Health Setting Facility Modifier None Typical Low $14.45 Median $21.88 Typical High $52.48 | Facility | None | $14.45 | $21.88 | $52.48 |
Emblem Health Setting Professional Modifier None Typical Low $9.33 Median $15.85 Typical High $25.70 | Professional | None | $9.33 | $15.85 | $25.70 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.72 Typical High $11.75 | Professional | None | $10.00 | $10.72 | $11.75 |
MVP Health Care Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
MVP Health Care Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $20.89 | Professional | None | $9.33 | $9.33 | $20.89 |
United Setting Professional Modifier None Typical Low $4.68 Median $7.76 Typical High $10.00 | Professional | None | $4.68 | $7.76 | $10.00 |
Univera Setting Facility Modifier None Typical Low $10.00 Median $10.72 Typical High $10.72 | Facility | None | $10.00 | $10.72 | $10.72 |
Univera Setting Professional Modifier None Typical Low $10.23 Median $10.72 Typical High $11.75 | Professional | None | $10.23 | $10.72 | $11.75 |
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 $0.91 Median $0.91 Typical High $2.00 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $1.35 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $1.35 |
Where New York sits
The same service costs 2.3 times more in Montana 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· 33rd of 51
$9.33
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.