How much rates vary
Facilitymedian $87 · 10th to 90th $60 to $126Professionalmedian $62 · 10th to 90th $60 to $102
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 $60.26 Median $74.13 Typical High $223.87 | Facility | None | $60.26 | $74.13 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $79.43 | Facility | None | $77.62 | $77.62 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $83.18 | Professional | None | $60.26 | $60.26 | $83.18 |
CDPHP Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $125.89 | Facility | None | $66.07 | $87.10 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Emblem Health Setting Facility Modifier None Typical Low $56.23 Median $69.18 Typical High $128.82 | Facility | None | $56.23 | $69.18 | $128.82 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | None | $61.66 | $61.66 | $66.07 |
Excellus BCBS Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $102.33 | Facility | None | $77.62 | $102.33 | $102.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Highmark BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $138.04 | Professional | None | $87.10 | $87.10 | $138.04 |
MVP Health Care Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $281.84 | Facility | None | $134.90 | $134.90 | $281.84 |
MVP Health Care Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $173.78 | Professional | None | $125.89 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $102.33 | Professional | None | $77.62 | $81.28 | $102.33 |
Univera Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $102.33 | Facility | None | $77.62 | $102.33 | $102.33 |
Univera Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Highmark BCBS Setting Facility Modifier JW · Drug discarded Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | JW · Drug discarded | $131.83 | $131.83 | $131.83 |
Where New York sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$61.66
HI $158CO $60.26
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.