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 $61.66 Median $63.10 Typical High $97.72 | Facility | None | $61.66 | $63.10 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $125.89 | Professional | None | $61.66 | $93.33 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $30.90 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.59 Typical High $14.45 | Professional | 55 · Aftercare only | $9.33 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.51 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.17 | $8.51 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
AmeriHealth Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $186.21 | Professional | None | $79.43 | $123.03 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $138.04 | Professional | None | $53.70 | $85.11 | $138.04 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $51.29 Typical High $173.78 | Professional | None | $30.90 | $51.29 | $173.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | None | $112.20 | $112.20 | $177.83 |
United Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $138.04 | Professional | None | $69.18 | $81.28 | $138.04 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $89.13 Median $107.15 Typical High $123.03 | Professional | 25 · Same-day visit | $89.13 | $107.15 | $123.03 |
Where New Jersey sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 44th of 51
$85.11
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.