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 $0.58 Median $0.63 Typical High $0.65 | Facility | None | $0.58 | $0.63 | $0.65 |
Aetna Setting Professional Modifier None Typical Low $0.63 Median $0.63 Typical High $0.65 | Professional | None | $0.63 | $0.63 | $0.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $1.55 | Facility | None | $0.78 | $0.78 | $1.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.72 Median $0.93 Typical High $1.74 | Professional | None | $0.72 | $0.93 | $1.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.07 Median $0.07 Typical High $1.00 | Professional | RR · Rental | $0.07 | $0.07 | $1.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.52 Median $0.72 Typical High $0.79 | Professional | UE · Used equipment | $0.52 | $0.72 | $0.79 |
CDPHP Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | None | $1.07 | $1.07 | $1.07 |
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 $1.82 Median $1.82 Typical High $21.38 | Professional | None | $1.82 | $1.82 | $21.38 |
Emblem Health Setting Facility Modifier None Typical Low $0.79 Median $1.29 Typical High $2.82 | Facility | None | $0.79 | $1.29 | $2.82 |
Emblem Health Setting Professional Modifier None Typical Low $0.79 Median $1.10 Typical High $1.51 | Professional | None | $0.79 | $1.10 | $1.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.98 Median $0.98 Typical High $1.05 | Facility | None | $0.98 | $0.98 | $1.05 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.98 Median $1.05 Typical High $1.12 | Professional | None | $0.98 | $1.05 | $1.12 |
MVP Health Care Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
MVP Health Care Setting Professional Modifier None Typical Low $0.47 Median $0.78 Typical High $1.66 | Professional | None | $0.47 | $0.78 | $1.66 |
United Setting Professional Modifier None Typical Low $0.48 Median $1.10 Typical High $1.62 | Professional | None | $0.48 | $1.10 | $1.62 |
Univera Setting Facility Modifier None Typical Low $0.98 Median $1.05 Typical High $1.05 | Facility | None | $0.98 | $1.05 | $1.05 |
Univera Setting Professional Modifier None Typical Low $0.98 Median $1.05 Typical High $1.12 | Professional | None | $0.98 | $1.05 | $1.12 |
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 $0.09 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
Where New York sits
The same service costs 3.2 times more in Texas 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· 24th of 51
$0.93
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.