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 $11.75 Median $14.13 Typical High $14.13 | Facility | None | $11.75 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $14.13 | Professional | None | $11.75 | $11.75 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $141.25 | Professional | None | $66.07 | $66.07 | $141.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $14.13 | Professional | RR · Rental | $6.61 | $6.61 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $48.98 Median $48.98 Typical High $87.10 | Professional | UE · Used equipment | $48.98 | $48.98 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Emblem Health Setting Professional Modifier None Typical Low $1.66 Median $2.09 Typical High $21.88 | Professional | None | $1.66 | $2.09 | $21.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
MVP Health Care Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
United Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $64.57 | Professional | None | $51.29 | $64.57 | $64.57 |
Univera Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.19 | Facility | None | $2.09 | $2.09 | $2.19 |
Univera Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
4 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 52 · Reduced service Typical Low $5.89 Median $5.89 Typical High $7.08 | Professional | 52 · Reduced service | $5.89 | $5.89 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $2.82 | Professional | 53 · Discontinued | $2.34 | $2.34 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $2.09 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $1.41 |
Where New York sits
The same service costs 27.5 times more in Kansas than in South Carolina. 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· 7th of 51
$66.07
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.