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 $2.29 Median $2.29 Typical High $4.79 | Facility | None | $2.29 | $2.29 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $4.79 Typical High $4.79 | Professional | None | $2.29 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $3.47 | Professional | None | $1.29 | $1.29 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $0.95 Typical High $1.38 | Professional | UE · Used equipment | $0.95 | $0.95 | $1.38 |
CDPHP Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
Emblem Health Setting Facility Modifier None Typical Low $2.51 Median $3.72 Typical High $9.12 | Facility | None | $2.51 | $3.72 | $9.12 |
Emblem Health Setting Professional Modifier None Typical Low $2.29 Median $2.75 Typical High $4.68 | Professional | None | $2.29 | $2.75 | $4.68 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.17 Median $0.17 Typical High $0.17 | Facility | None | $0.17 | $0.17 | $0.17 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $2.04 | Professional | None | $0.17 | $0.17 | $2.04 |
MVP Health Care Setting Facility Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Facility | None | $0.39 | $0.39 | $0.39 |
MVP Health Care Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $3.63 | Professional | None | $1.51 | $1.51 | $3.63 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.51 Typical High $1.86 | Professional | None | $0.81 | $1.51 | $1.86 |
Univera Setting Facility Modifier None Typical Low $0.17 Median $0.17 Typical High $0.20 | Facility | None | $0.17 | $0.17 | $0.20 |
Univera Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $2.04 | Professional | None | $0.17 | $0.17 | $2.04 |
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 $1.15 Median $2.40 Typical High $2.40 | Professional | 52 · Reduced service | $1.15 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.95 Typical High $0.95 | Professional | 53 · Discontinued | $0.46 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.35 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.48 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.23 | $0.48 | $0.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.31 | Professional | RR · Rental | $0.13 | $0.13 | $0.31 |
Where New York sits
The same service costs 4.6 times more in Rhode Island 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· 32nd of 51
$1.41
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.