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 $0.56 Median $0.56 Typical High $1.35 | Facility | None | $0.56 | $0.56 | $1.35 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | None | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | None | $0.56 | $0.56 | $0.56 |
Cigna Setting Facility Modifier None Typical Low $0.63 Median $0.83 Typical High $2.82 | Facility | None | $0.63 | $0.83 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Emblem Health Setting Facility Modifier None Typical Low $0.54 Median $2.04 Typical High $4.68 | Facility | None | $0.54 | $2.04 | $4.68 |
Emblem Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.63 | Professional | None | $0.55 | $0.55 | $0.63 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.46 Median $1.58 Typical High $2.29 | Facility | None | $0.46 | $1.58 | $2.29 |
MVP Health Care Setting Facility Modifier None Typical Low $0.50 Median $0.58 Typical High $4.68 | Facility | None | $0.50 | $0.58 | $4.68 |
MVP Health Care Setting Professional Modifier None Typical Low $0.59 Median $0.79 Typical High $0.79 | Professional | None | $0.59 | $0.79 | $0.79 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.68 Typical High $0.87 | Professional | None | $0.65 | $0.68 | $0.87 |
Univera Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.68 | Facility | None | $0.65 | $0.65 | $0.68 |
Univera Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | JZ · No drug discarded | $2.00 | $2.00 | $2.00 |
Highmark BCBS Setting Professional Modifier JZ · No drug discarded Typical Low $0.41 Median $0.66 Typical High $2.00 | Professional | JZ · No drug discarded | $0.41 | $0.66 | $2.00 |
Where New York sits
The same service costs 1.9 times more in Wyoming than in Oklahoma. 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· 41st of 51
$0.56
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.