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 $63.10 Median $70.79 Typical High $109.65 | Facility | None | $63.10 | $70.79 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $162.18 | Professional | None | $63.10 | $83.18 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $169.82 | Professional | None | $100.00 | $114.82 | $169.82 |
AmeriHealth Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $281.84 | Professional | None | $100.00 | $131.83 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $239.88 | Professional | None | $72.44 | $104.71 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $109.65 Typical High $173.78 | Professional | None | $30.90 | $109.65 | $173.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $263.03 | Professional | None | $102.33 | $131.83 | $263.03 |
United Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $186.21 | Professional | None | $60.26 | $75.86 | $186.21 |
4 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 $38.02 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $11.48 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.32 |
Ambetter Setting Professional Modifier AI · Physician of record Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | AI · Physician of record | $114.82 | $114.82 | $114.82 |
Where New Jersey sits
The same service costs 2.5 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
$93.33
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.