How much rates vary
Facilitymedian $20 · 10th to 90th $19 to $37Professionalmedian $19 · 10th to 90th $19 to $27
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 $18.62 Median $26.30 Typical High $58.88 | Facility | None | $18.62 | $26.30 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.89 | Facility | None | $20.42 | $20.42 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
CDPHP Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $19.95 Typical High $28.84 | Facility | None | $15.14 | $19.95 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Emblem Health Setting Facility Modifier None Typical Low $17.38 Median $21.38 Typical High $58.88 | Facility | None | $17.38 | $21.38 | $58.88 |
Emblem Health Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $18.62 | Professional | None | $15.85 | $18.62 | $18.62 |
Excellus BCBS Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
MVP Health Care Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $158.49 | Facility | None | $38.02 | $38.02 | $158.49 |
MVP Health Care Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $48.98 | Professional | None | $35.48 | $48.98 | $48.98 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $26.92 | Professional | None | $20.42 | $21.38 | $26.92 |
Univera Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $21.38 | Facility | None | $20.42 | $20.42 | $21.38 |
Univera Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
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 $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Highmark BCBS Setting Facility Modifier JW · Drug discarded Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | JW · Drug discarded | $72.44 | $72.44 | $72.44 |
Where New York sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 45th of 51
$18.62
HI $33.11OH $18.62
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.