How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $11Professionalmedian $4 · 10th to 90th $3 to $8
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 $2.24 Median $2.69 Typical High $3.89 | Facility | None | $2.24 | $2.69 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $3.89 | Professional | None | $2.69 | $2.69 | $3.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $12.59 | Facility | None | $6.31 | $6.31 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $10.47 | Professional | None | $3.55 | $3.55 | $10.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.74 | Professional | RR · Rental | $0.34 | $0.34 | $0.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $4.57 | Professional | UE · Used equipment | $2.57 | $2.57 | $4.57 |
CDPHP Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $4.57 | Facility | None | $3.55 | $3.55 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Emblem Health Setting Facility Modifier None Typical Low $6.31 Median $10.23 Typical High $22.39 | Facility | None | $6.31 | $10.23 | $22.39 |
Emblem Health Setting Professional Modifier None Typical Low $4.07 Median $6.31 Typical High $10.96 | Professional | None | $4.07 | $6.31 | $10.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.72 Typical High $5.13 | Professional | None | $3.16 | $3.72 | $5.13 |
MVP Health Care Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
MVP Health Care Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $9.12 | Professional | None | $3.80 | $3.80 | $9.12 |
United Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $10.00 | Facility | None | $7.59 | $7.59 | $10.00 |
United Setting Professional Modifier None Typical Low $2.04 Median $3.72 Typical High $4.27 | Professional | None | $2.04 | $3.72 | $4.27 |
Univera Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.72 | Facility | None | $3.16 | $3.16 | $3.72 |
Univera Setting Professional Modifier None Typical Low $3.16 Median $3.72 Typical High $5.13 | Professional | None | $3.16 | $3.72 | $5.13 |
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 $1.35 Median $1.35 Typical High $1.95 | Professional | 52 · Reduced service | $1.35 | $1.35 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.78 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $0.58 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.39 |
Where New York sits
The same service costs 4.9 times more in Kansas than in Delaware. 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· 31st of 51
$3.55
KS $14.45DE $2.95
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.