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 $28.84 Median $87.10 Typical High $114.82 | Facility | None | $28.84 | $87.10 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $87.10 Typical High $91.20 | Professional | None | $28.84 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $43.65 Typical High $45.71 | Professional | 52 · Reduced service | $14.45 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $17.38 Typical High $18.20 | Professional | 53 · Discontinued | $5.89 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $13.18 Typical High $13.49 | Professional | 55 · Aftercare only | $4.37 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $2.95 | $8.71 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $158.49 | Professional | None | $63.10 | $85.11 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $162.18 | Professional | None | $83.18 | $83.18 | $162.18 |
Horizon BCBS Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $100.00 | Professional | None | $85.11 | $91.20 | $100.00 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Facility | None | $75.86 | $75.86 | $85.11 |
United Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $151.36 | Professional | None | $51.29 | $74.13 | $151.36 |
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 GO · Occupational therapy plan Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | GO · Occupational therapy plan | $87.10 | $87.10 | $87.10 |
Where New Jersey sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 35th of 51
$85.11
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.