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 $0.45 Median $0.55 Typical High $0.63 | Facility | None | $0.45 | $0.55 | $0.63 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.63 | Professional | None | $0.55 | $0.55 | $0.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.87 Median $0.87 Typical High $1.74 | Facility | None | $0.87 | $0.87 | $1.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $1.95 | Professional | None | $0.74 | $0.74 | $1.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.07 Median $0.07 Typical High $1.74 | Professional | RR · Rental | $0.07 | $0.07 | $1.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.54 Median $0.74 Typical High $1.45 | Professional | UE · Used equipment | $0.54 | $0.74 | $1.45 |
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 $5.89 Median $5.89 Typical High $39.81 | Professional | None | $5.89 | $5.89 | $39.81 |
Emblem Health Setting Facility Modifier None Typical Low $0.89 Median $1.48 Typical High $3.24 | Facility | None | $0.89 | $1.48 | $3.24 |
Emblem Health Setting Professional Modifier None Typical Low $0.89 Median $1.70 Typical High $2.24 | Professional | None | $0.89 | $1.70 | $2.24 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $1.23 | Facility | None | $0.81 | $0.81 | $1.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.81 Median $0.83 Typical High $1.23 | Professional | None | $0.81 | $0.83 | $1.23 |
MVP Health Care Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
MVP Health Care Setting Professional Modifier None Typical Low $0.52 Median $0.87 Typical High $1.62 | Professional | None | $0.52 | $0.87 | $1.62 |
United Setting Professional Modifier None Typical Low $0.47 Median $1.00 Typical High $1.58 | Professional | None | $0.47 | $1.00 | $1.58 |
Univera Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $1.23 | Facility | None | $0.81 | $0.81 | $1.23 |
Univera Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $1.23 | Professional | None | $0.81 | $0.81 | $1.23 |
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 $0.08 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where New York sits
The same service costs 3.6 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· 39th of 51
$0.81
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.