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 $0.72 Typical High $0.72 | Facility | None | $0.58 | $0.72 | $0.72 |
Aetna Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | None | $0.72 | $0.72 | $0.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $6.17 Typical High $6.61 | Professional | None | $2.51 | $6.17 | $6.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.25 Median $0.25 Typical High $0.38 | Professional | RR · Rental | $0.25 | $0.25 | $0.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $1.86 Typical High $2.69 | Professional | UE · Used equipment | $1.86 | $1.86 | $2.69 |
CDPHP Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $21.88 | Professional | None | $8.13 | $8.13 | $21.88 |
Emblem Health Setting Professional Modifier None Typical Low $5.13 Median $5.25 Typical High $10.72 | Professional | None | $5.13 | $5.25 | $10.72 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.09 Median $5.37 Typical High $5.37 | Professional | None | $3.09 | $5.37 | $5.37 |
MVP Health Care Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Univera Setting Facility Modifier None Typical Low $3.09 Median $5.37 Typical High $5.37 | Facility | None | $3.09 | $5.37 | $5.37 |
Univera Setting Professional Modifier None Typical Low $3.09 Median $5.37 Typical High $5.37 | Professional | None | $3.09 | $5.37 | $5.37 |
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 $0.11 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where New York sits
The same service costs 158.5 times more in Montana than in Rhode Island. 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· 22nd of 51
$5.37
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.