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 $2.88 Median $3.24 Typical High $6.17 | Facility | None | $2.88 | $3.24 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $6.17 | Professional | None | $2.88 | $2.88 | $6.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $11.48 | Professional | None | $2.82 | $2.82 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.28 Median $0.28 Typical High $0.62 | Professional | RR · Rental | $0.28 | $0.28 | $0.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.09 Median $2.09 Typical High $4.17 | Professional | UE · Used equipment | $2.09 | $2.09 | $4.17 |
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 $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Emblem Health Setting Facility Modifier None Typical Low $6.76 Median $10.00 Typical High $23.99 | Facility | None | $6.76 | $10.00 | $23.99 |
Emblem Health Setting Professional Modifier None Typical Low $4.37 Median $7.08 Typical High $11.75 | Professional | None | $4.37 | $7.08 | $11.75 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.86 Median $4.79 Typical High $5.50 | Professional | None | $1.86 | $4.79 | $5.50 |
MVP Health Care Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
MVP Health Care Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $9.77 | Professional | None | $4.37 | $4.37 | $9.77 |
United Setting Professional Modifier None Typical Low $2.19 Median $4.07 Typical High $5.01 | Professional | None | $2.19 | $4.07 | $5.01 |
Univera Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $4.79 | Facility | None | $1.86 | $1.86 | $4.79 |
Univera Setting Professional Modifier None Typical Low $1.86 Median $4.79 Typical High $5.50 | Professional | None | $1.86 | $4.79 | $5.50 |
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 $0.43 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 2.2 times more in Minnesota 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
$4.07
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.