How much rates vary
Facilitymedian $25 · 10th to 90th $23 to $44Professionalmedian $25 · 10th to 90th $22 to $32
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 $24.55 Median $24.55 Typical High $52.48 | Facility | None | $24.55 | $24.55 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $24.55 | Facility | None | $23.99 | $23.99 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
CDPHP Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $28.84 Typical High $56.23 | Facility | None | $21.88 | $28.84 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Emblem Health Setting Facility Modifier None Typical Low $21.88 Median $26.92 Typical High $77.62 | Facility | None | $21.88 | $26.92 | $77.62 |
Emblem Health Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $21.88 | Professional | None | $18.62 | $21.88 | $21.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Facility | None | $23.99 | $23.99 | $26.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | None | $23.99 | $23.99 | $26.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $33.11 Median $36.31 Typical High $83.18 | Facility | None | $33.11 | $36.31 | $83.18 |
MVP Health Care Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $151.36 | Facility | None | $37.15 | $37.15 | $151.36 |
MVP Health Care Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $33.88 | Professional | None | $31.62 | $33.88 | $33.88 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $31.62 | Professional | None | $23.99 | $25.12 | $31.62 |
Univera Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Facility | None | $23.99 | $23.99 | $26.30 |
Univera Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | None | $23.99 | $23.99 | $26.30 |
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 $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Fidelis Setting Professional Modifier JW · Drug discarded Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | JW · Drug discarded | $24.55 | $24.55 | $24.55 |
Highmark BCBS Setting Professional Modifier JW · Drug discarded Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | JW · Drug discarded | $26.30 | $26.30 | $26.30 |
Where New York sits
The same service costs 2.8 times more in Wyoming than in North Carolina. 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· 32nd of 51
$24.55
WY $61.66NC $22.39
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.