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 $33.88 Median $51.29 Typical High $104.71 | Facility | None | $33.88 | $51.29 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $64.57 Typical High $104.71 | Professional | None | $33.88 | $64.57 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $32.36 Typical High $52.48 | Professional | 52 · Reduced service | $16.98 | $32.36 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $12.88 Typical High $20.89 | Professional | 53 · Discontinued | $6.76 | $12.88 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $9.77 Typical High $15.85 | Professional | 55 · Aftercare only | $5.13 | $9.77 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $6.46 Typical High $10.47 | Professional | 56 · Pre-op care only | $3.39 | $6.46 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $64.57 Typical High $72.44 | Professional | None | $28.18 | $64.57 | $72.44 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | None | $114.82 | $147.91 | $147.91 |
Horizon BCBS Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $616.60 | Facility | None | $295.12 | $489.78 | $616.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $114.82 | Professional | None | $97.72 | $104.71 | $114.82 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $562.34 | Facility | None | $257.04 | $257.04 | $562.34 |
United Setting Professional Modifier None Typical Low $19.50 Median $46.77 Typical High $66.07 | Professional | None | $19.50 | $46.77 | $66.07 |
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 2.5 times more in Alaska than in Washington, DC. 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· 48th of 51
$53.70
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.