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 $7.59 Median $8.71 Typical High $8.71 | Facility | None | $7.59 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $9.12 | Professional | None | $8.51 | $8.51 | $9.12 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $30.20 | Professional | None | $14.45 | $14.45 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.41 Median $1.41 Typical High $3.09 | Professional | RR · Rental | $1.41 | $1.41 | $3.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.72 Median $10.72 Typical High $19.05 | Professional | UE · Used equipment | $10.72 | $10.72 | $19.05 |
CDPHP Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Emblem Health Setting Professional Modifier None Typical Low $13.49 Median $22.91 Typical High $22.91 | Professional | None | $13.49 | $22.91 | $22.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.96 Median $11.75 Typical High $22.91 | Professional | None | $10.96 | $11.75 | $22.91 |
Highmark BCBS Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
MVP Health Care Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
MVP Health Care Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $6.46 Median $9.55 Typical High $14.79 | Professional | None | $6.46 | $9.55 | $14.79 |
Univera Setting Facility Modifier None Typical Low $10.96 Median $22.91 Typical High $22.91 | Facility | None | $10.96 | $22.91 | $22.91 |
Univera Setting Professional Modifier None Typical Low $10.96 Median $11.75 Typical High $22.91 | Professional | None | $10.96 | $11.75 | $22.91 |
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 $4.27 Median $4.27 Typical High $4.37 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $1.78 | Professional | 53 · Discontinued | $1.70 | $1.70 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.32 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.87 |
Where New York sits
The same service costs 6.2 times more in Wyoming than in North 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· 23rd of 51
$14.45
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.