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 $3.63 Median $4.07 Typical High $7.76 | Facility | None | $3.63 | $4.07 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $7.76 | Professional | None | $3.63 | $3.63 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $14.13 | Professional | None | $3.63 | $3.63 | $14.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.37 Median $0.37 Typical High $0.65 | Professional | RR · Rental | $0.37 | $0.37 | $0.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.75 Median $2.75 Typical High $5.50 | Professional | UE · Used equipment | $2.75 | $2.75 | $5.50 |
CDPHP Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Emblem Health Setting Facility Modifier None Typical Low $8.32 Median $12.59 Typical High $30.20 | Facility | None | $8.32 | $12.59 | $30.20 |
Emblem Health Setting Professional Modifier None Typical Low $7.76 Median $9.33 Typical High $15.85 | Professional | None | $7.76 | $9.33 | $15.85 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.23 Median $4.79 Typical High $6.92 | Professional | None | $1.23 | $4.79 | $6.92 |
MVP Health Care Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
MVP Health Care Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $12.30 | Professional | None | $5.13 | $5.13 | $12.30 |
United Setting Professional Modifier None Typical Low $2.75 Median $5.01 Typical High $6.03 | Professional | None | $2.75 | $5.01 | $6.03 |
Univera Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $4.79 | Facility | None | $1.23 | $1.23 | $4.79 |
Univera Setting Professional Modifier None Typical Low $1.23 Median $4.79 Typical High $6.92 | Professional | None | $1.23 | $4.79 | $6.92 |
4 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 $1.82 Median $1.82 Typical High $3.89 | Professional | 52 · Reduced service | $1.82 | $1.82 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $1.55 | Professional | 53 · Discontinued | $0.72 | $0.72 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $1.17 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.78 |
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· 29th of 51
$4.57
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.