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 $467.74 Median $602.56 Typical High $1,380.38 | Facility | None | $467.74 | $602.56 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | None | $467.74 | $467.74 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $478.63 | Facility | None | $467.74 | $467.74 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | None | $398.11 | $467.74 | $467.74 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $616.60 Typical High $691.83 | Facility | None | $512.86 | $616.60 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,995.26 | Professional | None | $467.74 | $467.74 | $1,995.26 |
Emblem Health Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $1,047.13 | Facility | None | $436.52 | $562.34 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,202.26 | Professional | None | $501.19 | $501.19 | $1,202.26 |
Excellus BCBS Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Facility | None | $467.74 | $467.74 | $489.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | None | $467.74 | $467.74 | $489.78 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $1,995.26 | Facility | None | $630.96 | $630.96 | $1,995.26 |
MVP Health Care Setting Professional Modifier None Typical Low $281.84 Median $588.84 Typical High $588.84 | Professional | None | $281.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $891.25 | Professional | None | $467.74 | $630.96 | $891.25 |
Univera Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Facility | None | $467.74 | $467.74 | $489.78 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $467.74 Typical High $489.78 | Professional | None | $204.17 | $467.74 | $489.78 |
3 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 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Highmark BCBS Setting Facility Modifier JZ · No drug discarded + TB · 340B drug Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | JZ · No drug discarded + TB · 340B drug | $1,230.27 | $1,230.27 | $1,230.27 |
Where New York sits
The same service costs 3.9 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· 40th of 51
$468
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.