How much rates vary
Facilitymedian $37 · 10th to 90th $37 to $65Professionalmedian $38 · 10th to 90th $37 to $44
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 $37.15 Median $40.74 Typical High $89.13 | Facility | None | $37.15 | $40.74 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $38.02 | Facility | None | $37.15 | $37.15 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
CDPHP Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $48.98 Typical High $56.23 | Facility | None | $31.62 | $48.98 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Emblem Health Setting Facility Modifier None Typical Low $35.48 Median $44.67 Typical High $83.18 | Facility | None | $35.48 | $44.67 | $83.18 |
Emblem Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Excellus BCBS Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Highmark BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
MVP Health Care Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $77.62 | Facility | None | $46.77 | $46.77 | $77.62 |
MVP Health Care Setting Professional Modifier None Typical Low $38.02 Median $43.65 Typical High $43.65 | Professional | None | $38.02 | $43.65 | $43.65 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $48.98 | Professional | None | $37.15 | $38.90 | $48.98 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $38.90 | Facility | None | $37.15 | $37.15 | $38.90 |
Univera Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
7 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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | JW · Drug discarded | $37.15 | $37.15 | $37.15 |
Fidelis Setting Professional Modifier JW · Drug discarded Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | JW · Drug discarded | $37.15 | $37.15 | $37.15 |
Highmark BCBS Setting Facility Modifier JW · Drug discarded Typical Low $36.31 Median $36.31 Typical High $52.48 | Facility | JW · Drug discarded | $36.31 | $36.31 | $52.48 |
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
$38.02
AK $47.86HI $37.15
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.