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 $0.26 Median $0.28 Typical High $0.30 | Facility | None | $0.26 | $0.28 | $0.30 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | None | $0.28 | $0.28 | $0.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.38 Median $0.38 Typical High $0.76 | Facility | None | $0.38 | $0.38 | $0.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.34 Median $0.47 Typical High $0.79 | Professional | None | $0.34 | $0.47 | $0.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.25 Median $0.34 Typical High $0.44 | Professional | UE · Used equipment | $0.25 | $0.34 | $0.44 |
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 $0.24 Median $0.24 Typical High $4.57 | Professional | None | $0.24 | $0.24 | $4.57 |
Emblem Health Setting Facility Modifier None Typical Low $0.39 Median $0.65 Typical High $1.41 | Facility | None | $0.39 | $0.65 | $1.41 |
Emblem Health Setting Professional Modifier None Typical Low $0.39 Median $0.58 Typical High $1.07 | Professional | None | $0.39 | $0.58 | $1.07 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.45 Median $0.45 Typical High $0.48 | Facility | None | $0.45 | $0.45 | $0.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.45 Median $0.48 Typical High $0.52 | Professional | None | $0.45 | $0.48 | $0.52 |
MVP Health Care Setting Facility Modifier None Typical Low $0.98 Median $0.98 Typical High $0.98 | Facility | None | $0.98 | $0.98 | $0.98 |
MVP Health Care Setting Professional Modifier None Typical Low $0.38 Median $0.51 Typical High $0.78 | Professional | None | $0.38 | $0.51 | $0.78 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.51 Typical High $0.78 | Professional | None | $0.23 | $0.51 | $0.78 |
Univera Setting Facility Modifier None Typical Low $0.45 Median $0.45 Typical High $0.48 | Facility | None | $0.45 | $0.45 | $0.48 |
Univera Setting Professional Modifier None Typical Low $0.45 Median $0.48 Typical High $0.52 | Professional | None | $0.45 | $0.48 | $0.52 |
3 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 $0.04 Median $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.06 Typical High $0.10 | Professional | RR · Rental | $0.04 | $0.06 | $0.10 |
Where New York sits
The same service costs 3.1 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· 18th of 51
$0.45
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.