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 $23.99 Median $27.54 Typical High $32.36 | Facility | None | $23.99 | $27.54 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $32.36 Typical High $83.18 | Professional | None | $23.99 | $32.36 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $75.86 | Professional | None | $50.12 | $74.13 | $75.86 |
AmeriHealth Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $112.20 | Professional | None | $37.15 | $56.23 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $95.50 | Professional | None | $27.54 | $41.69 | $95.50 |
Emblem Health Setting Professional Modifier None Typical Low $30.20 Median $45.71 Typical High $72.44 | Professional | None | $30.20 | $45.71 | $72.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $100.00 | Professional | None | $38.02 | $51.29 | $100.00 |
United Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $74.13 | Professional | None | $29.51 | $36.31 | $74.13 |
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 $14.13 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $14.13 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.27 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.82 | $3.24 | $3.24 |
Where New Jersey sits
The same service costs 2.7 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
$37.15
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.