How much rates vary
Facilitymedian $17 · 10th to 90th $10 to $30Professionalmedian $17 · 10th to 90th $17 to $20
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 $17.38 Median $17.38 Typical High $40.74 | Facility | None | $17.38 | $17.38 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $17.38 | Facility | None | $16.98 | $16.98 | $17.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
CDPHP Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $22.91 Typical High $31.62 | Facility | None | $13.80 | $22.91 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Emblem Health Setting Facility Modifier None Typical Low $16.22 Median $19.50 Typical High $58.88 | Facility | None | $16.22 | $19.50 | $58.88 |
Emblem Health Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.78 | Professional | None | $17.38 | $17.38 | $17.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $17.78 | Facility | None | $10.23 | $10.23 | $17.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $17.78 | Professional | None | $16.98 | $16.98 | $17.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $17.78 Median $19.50 Typical High $19.50 | Facility | None | $17.78 | $19.50 | $19.50 |
MVP Health Care Setting Facility Modifier None Typical Low $18.62 Median $21.38 Typical High $35.48 | Facility | None | $18.62 | $21.38 | $35.48 |
MVP Health Care Setting Professional Modifier None Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | None | $17.38 | $20.42 | $20.42 |
United Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $16.98 Median $17.78 Typical High $22.91 | Professional | None | $16.98 | $17.78 | $22.91 |
Univera Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $17.78 | Facility | None | $10.23 | $10.23 | $17.78 |
Univera Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $17.78 | Professional | None | $16.98 | $16.98 | $17.78 |
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 $8.51 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | JZ · No drug discarded | $17.38 | $17.38 | $17.38 |
Highmark BCBS Setting Professional Modifier JZ · No drug discarded Typical Low $16.60 Median $19.05 Typical High $22.39 | Professional | JZ · No drug discarded | $16.60 | $19.05 | $22.39 |
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· 15th of 51
$17.38
AK $21.88NC $16.98
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.