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 $5.62 Median $5.62 Typical High $70.79 | Facility | None | $5.62 | $5.62 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $6.17 Typical High $6.17 | Professional | None | $5.25 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.63 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.05 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.78 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.52 | $0.62 | $0.62 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $5.50 Typical High $5.75 | Professional | None | $3.89 | $5.50 | $5.75 |
AmeriHealth Setting Professional Modifier None Typical Low $4.57 Median $5.13 Typical High $11.48 | Professional | None | $4.57 | $5.13 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $4.07 Typical High $6.17 | Professional | None | $3.98 | $4.07 | $6.17 |
Emblem Health Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.62 | Professional | None | $4.27 | $4.27 | $5.62 |
Horizon BCBS Setting Facility Modifier None Typical Low $83.18 Median $125.89 Typical High $173.78 | Facility | None | $83.18 | $125.89 | $173.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $5.01 Median $5.89 Typical High $10.00 | Professional | None | $5.01 | $5.89 | $10.00 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $154.88 | Facility | None | $72.44 | $72.44 | $154.88 |
United Setting Professional Modifier None Typical Low $3.72 Median $4.90 Typical High $10.47 | Professional | None | $3.72 | $4.90 | $10.47 |
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 59 · Distinct service Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 59 · Distinct service | $5.50 | $5.50 | $5.75 |
Where New Jersey sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 18th of 51
$5.62
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.