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 $1.26 Median $1.41 Typical High $2.69 | Facility | None | $1.26 | $1.41 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $2.69 | Professional | None | $1.26 | $1.26 | $2.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $5.13 | Professional | None | $1.82 | $1.82 | $5.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $0.18 Typical High $0.39 | Professional | RR · Rental | $0.18 | $0.18 | $0.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.38 Median $1.38 Typical High $3.02 | Professional | UE · Used equipment | $1.38 | $1.38 | $3.02 |
CDPHP Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Emblem Health Setting Facility Modifier None Typical Low $2.95 Median $4.37 Typical High $10.72 | Facility | None | $2.95 | $4.37 | $10.72 |
Emblem Health Setting Professional Modifier None Typical Low $1.91 Median $3.09 Typical High $5.25 | Professional | None | $1.91 | $3.09 | $5.25 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.70 Median $1.74 Typical High $2.40 | Professional | None | $1.70 | $1.74 | $2.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
MVP Health Care Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
MVP Health Care Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $4.27 | Professional | None | $1.78 | $1.78 | $4.27 |
United Setting Professional Modifier None Typical Low $0.95 Median $1.78 Typical High $2.24 | Professional | None | $0.95 | $1.78 | $2.24 |
Univera Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $2.04 | Facility | None | $1.70 | $1.70 | $2.04 |
Univera Setting Professional Modifier None Typical Low $1.70 Median $1.74 Typical High $2.40 | Professional | None | $1.70 | $1.74 | $2.40 |
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 $0.63 Median $0.63 Typical High $1.35 | Professional | 52 · Reduced service | $0.63 | $0.63 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.54 | Professional | 53 · Discontinued | $0.25 | $0.25 | $0.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.41 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.27 |
Where New York sits
The same service costs 2.2 times more in Kansas than in Alabama. 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
$1.82
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.