How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $1Professionalmedian $1 · 10th to 90th $0 to $1
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 $0.27 Median $0.32 Typical High $0.46 | Facility | None | $0.27 | $0.32 | $0.46 |
Aetna Setting Professional Modifier None (both parts) Typical Low $0.32 Median $0.32 Typical High $0.46 | Professional | None (both parts) | $0.32 | $0.32 | $0.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.76 Median $0.78 Typical High $1.51 | Facility | None | $0.76 | $0.78 | $1.51 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $0.59 Median $0.62 Typical High $1.32 | Professional | None (both parts) | $0.59 | $0.62 | $1.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.06 Median $0.06 Typical High $0.11 | Professional | RR · Rental | $0.06 | $0.06 | $0.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.44 Median $0.59 Typical High $0.59 | Professional | UE · Used equipment | $0.44 | $0.59 | $0.59 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.54 | Facility | None | $0.42 | $0.42 | $0.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None (both parts) | $0.36 | $0.36 | $0.36 |
Emblem Health Setting Facility Modifier None Typical Low $0.76 Median $1.23 Typical High $2.69 | Facility | None | $0.76 | $1.23 | $2.69 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $0.49 Median $0.76 Typical High $1.32 | Professional | None (both parts) | $0.49 | $0.76 | $1.32 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.56 Median $0.56 Typical High $0.56 | Facility | None | $0.56 | $0.56 | $0.56 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $0.42 Median $0.56 Typical High $0.62 | Professional | None (both parts) | $0.42 | $0.56 | $0.62 |
MVP Health Care Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $0.45 Median $0.45 Typical High $1.10 | Professional | None (both parts) | $0.45 | $0.45 | $1.10 |
United Setting Facility Modifier None Typical Low $0.91 Median $0.91 Typical High $1.20 | Facility | None | $0.91 | $0.91 | $1.20 |
United Setting Professional Modifier None (both parts) Typical Low $0.24 Median $0.45 Typical High $0.51 | Professional | None (both parts) | $0.24 | $0.45 | $0.51 |
Univera Setting Facility Modifier None Typical Low $0.42 Median $0.56 Typical High $0.56 | Facility | None | $0.42 | $0.56 | $0.56 |
Univera Setting Professional Modifier None (both parts) Typical Low $0.42 Median $0.56 Typical High $0.62 | Professional | None (both parts) | $0.42 | $0.56 | $0.62 |
5 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 $0.16 Median $0.16 Typical High $0.23 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.09 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.05 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $0.59 Median $0.68 Typical High $1.17 | Professional | 26 · Professional part | $0.59 | $0.68 | $1.17 |
Where New York sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 19th of 51
$0.59
MT $0.81HI $0.35
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.