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 $0.34 Median $0.38 Typical High $0.72 | Facility | None | $0.34 | $0.38 | $0.72 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.72 | Professional | None | $0.34 | $0.34 | $0.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $1.35 | Professional | None | $0.38 | $0.38 | $1.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.28 Median $0.38 Typical High $0.41 | Professional | UE · Used equipment | $0.28 | $0.38 | $0.41 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Emblem Health Setting Facility Modifier None Typical Low $0.79 Median $1.20 Typical High $2.88 | Facility | None | $0.79 | $1.20 | $2.88 |
Emblem Health Setting Professional Modifier None Typical Low $0.74 Median $0.87 Typical High $1.51 | Professional | None | $0.74 | $0.87 | $1.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.08 Median $0.08 Typical High $0.08 | Facility | None | $0.08 | $0.08 | $0.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.08 Median $0.48 Typical High $0.65 | Professional | None | $0.08 | $0.48 | $0.65 |
MVP Health Care Setting Facility Modifier None Typical Low $0.19 Median $0.19 Typical High $0.19 | Facility | None | $0.19 | $0.19 | $0.19 |
MVP Health Care Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $1.15 | Professional | None | $0.48 | $0.48 | $1.15 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.48 Typical High $0.59 | Professional | None | $0.26 | $0.48 | $0.59 |
Univera Setting Facility Modifier None Typical Low $0.08 Median $0.08 Typical High $0.45 | Facility | None | $0.08 | $0.08 | $0.45 |
Univera Setting Professional Modifier None Typical Low $0.08 Median $0.45 Typical High $0.65 | Professional | None | $0.08 | $0.45 | $0.65 |
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 $0.17 Median $0.17 Typical High $0.37 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.15 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.11 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.07 |
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 Utah. 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
$0.41
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.