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 $162.18 Median $213.80 Typical High $3,311.31 | Facility | None | $162.18 | $213.80 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $331.13 | Professional | None | $169.82 | $218.78 | $331.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $104.71 Typical High $112.20 | Professional | 52 · Reduced service | $83.18 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.90 Typical High $33.88 | Professional | 55 · Aftercare only | $25.12 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $22.91 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $354.81 | Professional | None | $194.98 | $208.93 | $354.81 |
AmeriHealth Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $4,265.80 | Facility | None | $537.03 | $1,412.54 | $4,265.80 |
AmeriHealth Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $1,096.48 | Professional | None | $213.80 | $213.80 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $3,090.30 | Facility | None | $1,659.59 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $371.54 | Professional | None | $162.18 | $213.80 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $562.34 | Professional | None | $363.08 | $467.74 | $562.34 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $3,890.45 | Facility | None | $1,862.09 | $2,818.38 | $3,890.45 |
Horizon BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $478.63 | Professional | None | $269.15 | $269.15 | $478.63 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $3,467.37 | Facility | None | $1,584.89 | $1,584.89 | $3,467.37 |
United Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $295.12 | Professional | None | $144.54 | $204.17 | $295.12 |
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 Facility Modifier 25 · Same-day visit Typical Low $812.83 Median $1,949.84 Typical High $5,248.07 | Facility | 25 · Same-day visit | $812.83 | $1,949.84 | $5,248.07 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $169.82 Median $234.42 Typical High $446.68 | Professional | 25 · Same-day visit | $169.82 | $234.42 | $446.68 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | GC · Resident with teaching physician | $204.17 | $275.42 | $275.42 |
Where New Jersey sits
The same service costs 2.8 times more in Minnesota 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
$214
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.