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 $58.88 Median $67.61 Typical High $79.43 | Facility | None | $58.88 | $67.61 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $158.49 | Professional | None | $58.88 | $79.43 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $128.82 | Professional | None | $102.33 | $107.15 | $128.82 |
AmeriHealth Setting Facility Modifier None Typical Low $107.15 Median $5,495.41 Typical High $8,317.64 | Facility | None | $107.15 | $5,495.41 | $8,317.64 |
AmeriHealth Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $288.40 | Professional | None | $89.13 | $109.65 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $213.80 | Professional | None | $70.79 | $83.18 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $77.62 Typical High $125.89 | Professional | None | $30.90 | $77.62 | $125.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $218.78 | Professional | None | $109.65 | $120.23 | $218.78 |
United Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $181.97 | Professional | None | $53.70 | $74.13 | $181.97 |
3 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 $37.15 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $37.15 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.22 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $7.94 |
Where New Jersey sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 49th of 51
$83.18
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.