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 $16.60 Median $26.92 Typical High $43.65 | Facility | None | $16.60 | $26.92 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $26.92 Typical High $45.71 | Professional | None | $14.79 | $26.92 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $69.18 | Professional | None | $56.23 | $66.07 | $69.18 |
AmeriHealth Setting Facility Modifier None Typical Low $36.31 Median $288.40 Typical High $512.86 | Facility | None | $36.31 | $288.40 | $512.86 |
AmeriHealth Setting Professional Modifier None Typical Low $33.88 Median $45.71 Typical High $104.71 | Professional | None | $33.88 | $45.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $223.87 | Facility | None | $151.36 | $151.36 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $41.69 Typical High $57.54 | Professional | None | $26.30 | $41.69 | $57.54 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $42.66 Typical High $91.20 | Professional | None | $30.90 | $42.66 | $91.20 |
Horizon BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $85.11 | Professional | None | $48.98 | $48.98 | $85.11 |
United Setting Professional Modifier None Typical Low $20.89 Median $33.88 Typical High $56.23 | Professional | None | $20.89 | $33.88 | $56.23 |
6 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $16.22 Typical High $21.88 | Professional | 52 · Reduced service | $9.77 | $16.22 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $4.79 Typical High $6.46 | Professional | 55 · Aftercare only | $2.95 | $4.79 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $3.24 Typical High $4.37 | Professional | 56 · Pre-op care only | $1.95 | $3.24 | $4.37 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $34.67 Median $45.71 Typical High $97.72 | Professional | AF · Specialist physician | $34.67 | $45.71 | $97.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $50.12 Median $66.07 Typical High $102.33 | Professional | 25 · Same-day visit | $50.12 | $66.07 | $102.33 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 93 · Audio-only telehealth | $56.23 | $61.66 | $66.07 |
Where New Jersey sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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· 51st of 51
$32.36
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.