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 $25.70 Median $35.48 Typical High $97.72 | Facility | None | $25.70 | $35.48 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $61.66 Typical High $97.72 | Professional | None | $25.70 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $25.70 Typical High $48.98 | Professional | 52 · Reduced service | $12.88 | $25.70 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $12.30 Typical High $19.95 | Professional | 53 · Discontinued | $5.13 | $12.30 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $9.33 Typical High $14.79 | Professional | 55 · Aftercare only | $3.89 | $9.33 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $6.17 Typical High $9.77 | Professional | 56 · Pre-op care only | $2.57 | $6.17 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $64.57 Typical High $72.44 | Professional | None | $20.42 | $64.57 | $72.44 |
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 $295.12 Median $446.68 Typical High $616.60 | Facility | None | $295.12 | $446.68 | $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 $14.13 Median $38.90 Typical High $67.61 | Professional | None | $14.13 | $38.90 | $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 3.5 times more in Hawaii 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· 37th 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.