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 $0.78 Median $0.87 Typical High $1.70 | Facility | None | $0.78 | $0.87 | $1.70 |
Aetna Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $1.66 | Professional | None | $0.78 | $0.78 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $3.09 | Professional | None | $0.79 | $0.79 | $3.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.59 Median $0.59 Typical High $1.02 | Professional | UE · Used equipment | $0.59 | $0.59 | $1.02 |
CDPHP Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Emblem Health Setting Facility Modifier None Typical Low $1.78 Median $2.69 Typical High $6.46 | Facility | None | $1.78 | $2.69 | $6.46 |
Emblem Health Setting Professional Modifier None Typical Low $1.62 Median $1.95 Typical High $3.39 | Professional | None | $1.62 | $1.95 | $3.39 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Facility | None | $0.81 | $0.81 | $0.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.81 Median $1.02 Typical High $1.48 | Professional | None | $0.81 | $1.02 | $1.48 |
MVP Health Care Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
MVP Health Care Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $2.63 | Professional | None | $1.10 | $1.10 | $2.63 |
United Setting Professional Modifier None Typical Low $0.59 Median $1.07 Typical High $1.29 | Professional | None | $0.59 | $1.07 | $1.29 |
Univera Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $1.02 | Facility | None | $0.81 | $0.81 | $1.02 |
Univera Setting Professional Modifier None Typical Low $0.81 Median $1.02 Typical High $1.48 | Professional | None | $0.81 | $1.02 | $1.48 |
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 $0.39 Median $0.39 Typical High $0.83 | Professional | 52 · Reduced service | $0.39 | $0.39 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.33 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.25 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.10 Median $0.15 Typical High $0.25 | Professional | RR · Rental | $0.10 | $0.15 | $0.25 |
Where New York sits
The same service costs 2.5 times more in Idaho 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· 33rd of 51
$0.95
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.