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 $223.87 Median $275.42 Typical High $645.65 | Facility | None | $223.87 | $275.42 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $229.09 | Facility | None | $223.87 | $223.87 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $302.00 Typical High $338.84 | Facility | None | $251.19 | $302.00 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Emblem Health Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $478.63 | Facility | None | $213.80 | $245.47 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | None | $218.78 | $218.78 | $239.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $229.09 | Facility | None | $223.87 | $223.87 | $229.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | None | $223.87 | $223.87 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $457.09 | Facility | None | $275.42 | $275.42 | $457.09 |
MVP Health Care Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | None | $229.09 | $275.42 | $275.42 |
United Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $295.12 | Professional | None | $223.87 | $234.42 | $295.12 |
Univera Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $234.42 | Facility | None | $223.87 | $223.87 | $234.42 |
Univera Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | None | $223.87 | $223.87 | $229.09 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Highmark BCBS Setting Facility Modifier JW · Drug discarded Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | JW · Drug discarded | $213.80 | $213.80 | $213.80 |
Where New York sits
Rates are fairly even across states for this service. 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· 19th of 51
$229
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.