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 $38.90 Median $60.26 Typical High $109.65 | Facility | None | $38.90 | $60.26 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $66.07 Typical High $109.65 | Professional | None | $38.90 | $66.07 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $33.11 Typical High $54.95 | Professional | 52 · Reduced service | $19.50 | $33.11 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.18 Typical High $21.88 | Professional | 53 · Discontinued | $7.76 | $13.18 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.00 Typical High $16.22 | Professional | 55 · Aftercare only | $5.89 | $10.00 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.61 Typical High $10.96 | Professional | 56 · Pre-op care only | $3.89 | $6.61 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $72.44 Typical High $75.86 | Professional | None | $33.88 | $72.44 | $75.86 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | None | $120.23 | $151.36 | $151.36 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,513.56 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | None | $102.33 | $109.65 | $120.23 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,862.09 | Facility | None | $851.14 | $851.14 | $1,862.09 |
United Setting Professional Modifier None Typical Low $22.91 Median $46.77 Typical High $67.61 | Professional | None | $22.91 | $46.77 | $67.61 |
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 |
|---|---|---|---|---|---|
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 2.8 times more in Alaska than in Maryland. 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
$57.54
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.