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 $0.41 Median $0.46 Typical High $0.91 | Facility | None | $0.41 | $0.46 | $0.91 |
Aetna Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.91 | Professional | None | $0.41 | $0.41 | $0.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $1.62 | Professional | None | $0.42 | $0.42 | $1.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.32 Median $0.42 Typical High $0.42 | Professional | UE · Used equipment | $0.32 | $0.42 | $0.42 |
Cigna Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Emblem Health Setting Facility Modifier None Typical Low $0.98 Median $1.45 Typical High $3.47 | Facility | None | $0.98 | $1.45 | $3.47 |
Emblem Health Setting Professional Modifier None Typical Low $0.87 Median $1.07 Typical High $1.82 | Professional | None | $0.87 | $1.07 | $1.82 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Facility | None | $0.71 | $0.71 | $0.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.54 Median $0.71 Typical High $0.79 | Professional | None | $0.54 | $0.71 | $0.79 |
MVP Health Care Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
MVP Health Care Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $1.41 | Professional | None | $0.59 | $0.59 | $1.41 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.58 Typical High $0.71 | Professional | None | $0.32 | $0.58 | $0.71 |
Univera Setting Facility Modifier None Typical Low $0.55 Median $0.71 Typical High $0.71 | Facility | None | $0.55 | $0.71 | $0.71 |
Univera Setting Professional Modifier None Typical Low $0.54 Median $0.71 Typical High $0.79 | Professional | None | $0.54 | $0.71 | $0.79 |
5 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 $0.21 Median $0.21 Typical High $0.46 | Professional | 52 · Reduced service | $0.21 | $0.21 | $0.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.18 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.14 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.08 Typical High $0.12 | Professional | RR · Rental | $0.05 | $0.08 | $0.12 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 26th of 51
$0.56
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.