How much rates vary
Facilitymedian $141 · 10th to 90th $138 to $245Professionalmedian $145 · 10th to 90th $138 to $170
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 $138.04 Median $158.49 Typical High $398.11 | Facility | None | $138.04 | $158.49 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Facility | None | $138.04 | $138.04 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
CDPHP Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $181.97 Typical High $213.80 | Facility | None | $120.23 | $181.97 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Emblem Health Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $316.23 | Facility | None | $134.90 | $169.82 | $316.23 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | None | $154.88 | $154.88 | $158.49 |
Excellus BCBS Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Facility | None | $138.04 | $138.04 | $141.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | None | $138.04 | $138.04 | $141.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $288.40 | Facility | None | $173.78 | $173.78 | $288.40 |
MVP Health Care Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | None | $141.25 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
United Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $181.97 | Professional | None | $138.04 | $144.54 | $181.97 |
Univera Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $144.54 | Facility | None | $138.04 | $138.04 | $144.54 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | None | $138.04 | $138.04 | $141.25 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Highmark BCBS Setting Professional Modifier JZ · No drug discarded Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | JZ · No drug discarded | $162.18 | $162.18 | $162.18 |
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· 20th of 51
$145
AK $178TN $145
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.