How much rates vary
Facilitymedian $129 · 10th to 90th $129 to $209Professionalmedian $129 · 10th to 90th $129 to $162
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 $128.82 Median $128.82 Typical High $380.19 | Facility | None | $128.82 | $128.82 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | None | $128.82 | $128.82 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Facility | None | $128.82 | $128.82 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $263.03 | Professional | None | $128.82 | $128.82 | $263.03 |
CDPHP Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $194.98 | Facility | None | $128.82 | $169.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $549.54 | Professional | None | $128.82 | $128.82 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $123.03 Median $141.25 Typical High $275.42 | Facility | None | $123.03 | $141.25 | $275.42 |
Emblem Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | None | $128.82 | $128.82 | $154.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $131.83 | Facility | None | $128.82 | $128.82 | $131.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | None | $128.82 | $128.82 | $131.83 |
MVP Health Care Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $269.15 | Facility | None | $165.96 | $165.96 | $269.15 |
MVP Health Care Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $186.21 | Professional | None | $128.82 | $162.18 | $186.21 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $181.97 | Professional | None | $128.82 | $138.04 | $181.97 |
Univera Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $134.90 | Facility | None | $128.82 | $128.82 | $134.90 |
Univera Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | None | $128.82 | $128.82 | $131.83 |
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 $64.57 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $12.88 |
Highmark BCBS Setting Facility Modifier JZ · No drug discarded Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | JZ · No drug discarded | $162.18 | $162.18 | $162.18 |
Where New York sits
The same service costs 1.6 times more in Texas 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· 47th of 51
$129
TX $204NC $129
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.