How much rates vary
Facilitymedian $389 · 10th to 90th $380 to $646Professionalmedian $389 · 10th to 90th $380 to $513
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 $380.19 Median $398.11 Typical High $1,122.02 | Facility | None | $380.19 | $398.11 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Facility | None | $380.19 | $380.19 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $478.63 | Professional | None | $389.05 | $389.05 | $478.63 |
CDPHP Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $512.86 Typical High $575.44 | Facility | None | $323.59 | $512.86 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $1,621.81 | Professional | None | $389.05 | $389.05 | $1,621.81 |
Emblem Health Setting Facility Modifier None Typical Low $363.08 Median $446.68 Typical High $831.76 | Facility | None | $363.08 | $446.68 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | None | $398.11 | $398.11 | $478.63 |
Excellus BCBS Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $389.05 | Facility | None | $380.19 | $380.19 | $389.05 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | None | $380.19 | $380.19 | $389.05 |
MVP Health Care Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $812.83 | Facility | None | $478.63 | $478.63 | $812.83 |
MVP Health Care Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $467.74 | Professional | None | $288.40 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $512.86 | Professional | None | $354.81 | $407.38 | $512.86 |
Univera Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Facility | None | $380.19 | $380.19 | $398.11 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $389.05 | Professional | None | $204.17 | $380.19 | $389.05 |
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 $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Highmark BCBS Setting Facility Modifier JZ · No drug discarded Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | JZ · No drug discarded | $380.19 | $380.19 | $380.19 |
Where New York sits
The same service costs 11.5 times more in Alabama 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· 47th of 51
$389
AL $3,311OK $288
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.