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 $0.32 Median $0.35 Typical High $0.37 | Facility | None | $0.32 | $0.35 | $0.37 |
Aetna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.37 | Professional | None | $0.35 | $0.35 | $0.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.45 Median $0.45 Typical High $0.89 | Facility | None | $0.45 | $0.45 | $0.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.41 Median $0.69 Typical High $0.85 | Professional | None | $0.41 | $0.69 | $0.85 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.50 Median $0.69 Typical High $1.02 | Professional | RR · Rental | $0.50 | $0.69 | $1.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.30 Median $0.41 Typical High $0.45 | Professional | UE · Used equipment | $0.30 | $0.41 | $0.45 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $4.57 | Professional | None | $0.33 | $0.33 | $4.57 |
Emblem Health Setting Facility Modifier None Typical Low $0.46 Median $0.76 Typical High $1.66 | Facility | None | $0.46 | $0.76 | $1.66 |
Emblem Health Setting Professional Modifier None Typical Low $0.46 Median $0.81 Typical High $0.87 | Professional | None | $0.46 | $0.81 | $0.87 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.59 Median $0.59 Typical High $0.59 | Facility | None | $0.59 | $0.59 | $0.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.58 Median $0.59 Typical High $0.62 | Professional | None | $0.58 | $0.59 | $0.62 |
MVP Health Care Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
MVP Health Care Setting Professional Modifier None Typical Low $0.45 Median $0.62 Typical High $0.95 | Professional | None | $0.45 | $0.62 | $0.95 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.62 Typical High $0.93 | Professional | None | $0.28 | $0.62 | $0.93 |
Univera Setting Facility Modifier None Typical Low $0.58 Median $0.59 Typical High $0.59 | Facility | None | $0.58 | $0.59 | $0.59 |
Univera Setting Professional Modifier None Typical Low $0.58 Median $0.59 Typical High $0.62 | Professional | None | $0.58 | $0.59 | $0.62 |
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 $0.05 Median $0.05 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where New York sits
The same service costs 3.0 times more in Florida 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· 13th of 51
$0.59
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.