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 $2.45 Median $3.47 Typical High $4.47 | Facility | None | $2.45 | $3.47 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.47 | Professional | None | $3.47 | $3.47 | $4.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $13.49 | Facility | None | $6.76 | $6.76 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $10.00 Typical High $15.14 | Professional | None | $5.25 | $10.00 | $15.14 |
CDPHP Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
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 $5.75 Median $5.75 Typical High $218.78 | Professional | None | $5.75 | $5.75 | $218.78 |
Emblem Health Setting Facility Modifier None Typical Low $6.92 Median $11.22 Typical High $24.55 | Facility | None | $6.92 | $11.22 | $24.55 |
Emblem Health Setting Professional Modifier None Typical Low $6.92 Median $8.32 Typical High $19.05 | Professional | None | $6.92 | $8.32 | $19.05 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $4.17 | Professional | None | $3.89 | $3.89 | $4.17 |
MVP Health Care Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
MVP Health Care Setting Professional Modifier None Typical Low $4.17 Median $6.76 Typical High $11.48 | Professional | None | $4.17 | $6.76 | $11.48 |
United Setting Professional Modifier None Typical Low $3.39 Median $6.31 Typical High $10.47 | Professional | None | $3.39 | $6.31 | $10.47 |
Univera Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Univera Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $4.17 | Professional | None | $3.89 | $3.89 | $4.17 |
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 $0.52 Median $0.52 Typical High $0.68 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.43 Median $0.48 Typical High $0.48 | Professional | RR · Rental | $0.43 | $0.48 | $0.48 |
Where New York sits
The same service costs 83.2 times more in Kansas than in Indiana. 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· 47th of 51
$4.47
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.