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 $3.80 Median $4.07 Typical High $4.27 | Facility | None | $3.80 | $4.07 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.27 | Professional | None | $4.07 | $4.07 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $10.23 | Facility | None | $5.13 | $5.13 | $10.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $12.88 | Professional | None | $4.57 | $4.57 | $12.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.44 Median $0.44 Typical High $0.76 | Professional | RR · Rental | $0.44 | $0.44 | $0.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.31 Median $3.31 Typical High $4.79 | Professional | UE · Used equipment | $3.31 | $3.31 | $4.79 |
CDPHP Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $26.92 | Professional | None | $2.57 | $2.57 | $26.92 |
Emblem Health Setting Facility Modifier None Typical Low $5.25 Median $8.71 Typical High $19.05 | Facility | None | $5.25 | $8.71 | $19.05 |
Emblem Health Setting Professional Modifier None Typical Low $5.25 Median $6.31 Typical High $14.45 | Professional | None | $5.25 | $6.31 | $14.45 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.37 Median $6.92 Typical High $6.92 | Facility | None | $4.37 | $6.92 | $6.92 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $7.41 | Professional | None | $5.25 | $6.92 | $7.41 |
MVP Health Care Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
MVP Health Care Setting Professional Modifier None Typical Low $5.13 Median $7.24 Typical High $10.96 | Professional | None | $5.13 | $7.24 | $10.96 |
United Setting Professional Modifier None Typical Low $3.16 Median $7.08 Typical High $10.72 | Professional | None | $3.16 | $7.08 | $10.72 |
Univera Setting Facility Modifier None Typical Low $4.37 Median $6.92 Typical High $6.92 | Facility | None | $4.37 | $6.92 | $6.92 |
Univera Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $7.41 | Professional | None | $6.92 | $6.92 | $7.41 |
2 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 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.63 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.42 |
Where New York sits
The same service costs 4.2 times more in Kansas than in Delaware. 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· 16th of 51
$6.61
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.