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 $0.38 Median $0.42 Typical High $0.83 | Facility | None | $0.38 | $0.42 | $0.83 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.83 | Professional | None | $0.38 | $0.38 | $0.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $1.51 | Professional | None | $0.38 | $0.38 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.28 Median $0.38 Typical High $0.69 | Professional | UE · Used equipment | $0.28 | $0.38 | $0.69 |
Cigna Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Emblem Health Setting Facility Modifier None Typical Low $0.89 Median $1.35 Typical High $3.24 | Facility | None | $0.89 | $1.35 | $3.24 |
Emblem Health Setting Professional Modifier None Typical Low $0.81 Median $1.00 Typical High $1.70 | Professional | None | $0.81 | $1.00 | $1.70 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Facility | None | $0.40 | $0.40 | $0.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.40 Median $0.52 Typical High $0.72 | Professional | None | $0.40 | $0.52 | $0.72 |
MVP Health Care Setting Facility Modifier None Typical Low $0.87 Median $0.87 Typical High $0.87 | Facility | None | $0.87 | $0.87 | $0.87 |
MVP Health Care Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $1.32 | Professional | None | $0.65 | $0.65 | $1.32 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.54 Typical High $0.66 | Professional | None | $0.28 | $0.54 | $0.66 |
Univera Setting Facility Modifier None Typical Low $0.40 Median $0.40 Typical High $0.49 | Facility | None | $0.40 | $0.40 | $0.49 |
Univera Setting Professional Modifier None Typical Low $0.40 Median $0.49 Typical High $0.72 | Professional | None | $0.40 | $0.49 | $0.72 |
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 $0.19 Median $0.19 Typical High $0.42 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.17 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.12 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.06 Median $0.09 Typical High $0.17 | Professional | RR · Rental | $0.06 | $0.09 | $0.17 |
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
$0.47
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.