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 $134.90 Median $154.88 Typical High $181.97 | Facility | None | $134.90 | $154.88 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $302.00 | Professional | None | $134.90 | $181.97 | $302.00 |
AmeriHealth Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $616.60 | Professional | None | $208.93 | $234.42 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $426.58 | Professional | None | $151.36 | $213.80 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $371.54 | Professional | None | $208.93 | $281.84 | $371.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $467.74 | Professional | None | $213.80 | $281.84 | $467.74 |
United Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $389.05 | Professional | None | $134.90 | $181.97 | $389.05 |
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 $79.43 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $79.43 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $18.20 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | GC · Resident with teaching physician | $331.13 | $331.13 | $331.13 |
Where New Jersey sits
The same service costs 2.4 times more in Alaska than in Utah. 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
$182
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.