How much rates vary
Facilitymedian $200 · 10th to 90th $200 to $355Professionalmedian $204 · 10th to 90th $195 to $240
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 $199.53 Median $245.47 Typical High $588.84 | Facility | None | $199.53 | $245.47 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $208.93 | Facility | None | $199.53 | $199.53 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $309.03 | Facility | None | $223.87 | $269.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Emblem Health Setting Facility Modifier None Typical Low $194.98 Median $223.87 Typical High $436.52 | Facility | None | $194.98 | $223.87 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | None | $194.98 | $194.98 | $218.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | None | $199.53 | $199.53 | $204.17 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $426.58 | Facility | None | $251.19 | $251.19 | $426.58 |
MVP Health Care Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | None | $204.17 | $239.88 | $239.88 |
United Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $269.15 | Professional | None | $199.53 | $213.80 | $269.15 |
Univera Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Facility | None | $199.53 | $199.53 | $213.80 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | None | $199.53 | $199.53 | $204.17 |
6 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 $102.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Highmark BCBS Setting Facility Modifier JZ · No drug discarded Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | JZ · No drug discarded | $194.98 | $194.98 | $194.98 |
Highmark BCBS Setting Professional Modifier JZ · No drug discarded Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | JZ · No drug discarded | $234.42 | $239.88 | $239.88 |
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· 25th of 51
$204
AK $251NJ $204
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.