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 $2.04 Median $2.29 Typical High $4.47 | Facility | None | $2.04 | $2.29 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $4.47 | Professional | None | $2.04 | $2.04 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $8.32 | Professional | None | $3.02 | $3.02 | $8.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.30 Median $0.30 Typical High $0.65 | Professional | RR · Rental | $0.30 | $0.30 | $0.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.24 Median $2.24 Typical High $4.47 | Professional | UE · Used equipment | $2.24 | $2.24 | $4.47 |
CDPHP Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $3.09 | Facility | None | $2.69 | $2.82 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Emblem Health Setting Facility Modifier None Typical Low $4.79 Median $7.24 Typical High $17.38 | Facility | None | $4.79 | $7.24 | $17.38 |
Emblem Health Setting Professional Modifier None Typical Low $3.16 Median $5.13 Typical High $8.51 | Professional | None | $3.16 | $5.13 | $8.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.82 Median $3.31 Typical High $3.98 | Professional | None | $2.82 | $3.31 | $3.98 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
MVP Health Care Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
MVP Health Care Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $7.08 | Professional | None | $2.95 | $2.95 | $7.08 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.95 Typical High $3.63 | Professional | None | $1.58 | $2.95 | $3.63 |
Univera Setting Facility Modifier None Typical Low $2.82 Median $3.31 Typical High $3.39 | Facility | None | $2.82 | $3.31 | $3.39 |
Univera Setting Professional Modifier None Typical Low $2.82 Median $3.31 Typical High $3.98 | Professional | None | $2.82 | $3.31 | $3.98 |
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 $1.02 Median $1.02 Typical High $2.24 | Professional | 52 · Reduced service | $1.02 | $1.02 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.41 Typical High $0.89 | Professional | 53 · Discontinued | $0.41 | $0.41 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.31 Typical High $0.68 | Professional | 55 · Aftercare only | $0.31 | $0.31 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.45 |
Where New York sits
The same service costs 2.2 times more in Kansas than in New Jersey. 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· 30th of 51
$3.02
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.