How much rates vary
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 $35.48 Median $204.17 Typical High $10,471.29 | Facility | None | $35.48 | $204.17 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $151.36 Typical High $263.03 | Professional | None | $35.48 | $151.36 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $60.26 Typical High $112.20 | Professional | 52 · Reduced service | $17.78 | $60.26 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $23.99 Typical High $44.67 | Professional | 53 · Discontinued | $7.08 | $23.99 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $21.88 Typical High $33.88 | Professional | 55 · Aftercare only | $5.37 | $21.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $12.02 Typical High $22.39 | Professional | 56 · Pre-op care only | $3.55 | $12.02 | $22.39 |
AmeriHealth Setting Facility Modifier None Typical Low $87.10 Median $177.83 Typical High $1,000.00 | Facility | None | $87.10 | $177.83 | $1,000.00 |
AmeriHealth Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $208.93 | Professional | None | $38.02 | $38.02 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $117.49 Typical High $302.00 | Professional | None | $40.74 | $117.49 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | None | $251.19 | $346.74 | $346.74 |
Horizon BCBS Setting Professional Modifier None Typical Low $40.74 Median $223.87 Typical High $407.38 | Professional | None | $40.74 | $223.87 | $407.38 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,148.15 | $3,311.31 | $5,888.44 |
United Setting Professional Modifier None Typical Low $29.51 Median $147.91 Typical High $281.84 | Professional | None | $29.51 | $147.91 | $281.84 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | GC · Resident with teaching physician | $58.88 | $58.88 | $58.88 |
Where New Jersey sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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 Jersey· 40th of 51
$151
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.