How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $43.65 Median $61.66 Typical High $102.33 | Facility | None | $43.65 | $61.66 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $69.18 Typical High $102.33 | Professional | None | $43.65 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $33.88 Typical High $51.29 | Professional | 52 · Reduced service | $21.88 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.80 Typical High $20.42 | Professional | 53 · Discontinued | $8.71 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.23 Typical High $15.14 | Professional | 55 · Aftercare only | $6.61 | $10.23 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.92 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.37 | $6.92 | $10.23 |
AmeriHealth Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $100.00 | Professional | None | $81.28 | $81.28 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $69.18 Typical High $75.86 | Professional | None | $38.02 | $69.18 | $75.86 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $154.88 | Professional | None | $123.03 | $154.88 | $154.88 |
Horizon BCBS Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | None | $97.72 | $107.15 | $114.82 |
United Setting Professional Modifier None Typical Low $26.30 Median $47.86 Typical High $69.18 | Professional | None | $26.30 | $47.86 | $69.18 |
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 |
|---|---|---|---|---|---|
AmeriHealth Setting Professional Modifier NDW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NDW | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier NES Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NES | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier NEW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NEW | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier NNW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NNW | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier PL · Progressive lenses Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | PL · Progressive lenses | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where New Jersey sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 50th of 51
$61.66
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.