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 $67.61 Median $70.79 Typical High $104.71 | Facility | None | $67.61 | $70.79 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $125.89 | Professional | None | $69.18 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $33.11 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $10.00 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.76 | $8.91 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $169.82 | Professional | None | $131.83 | $131.83 | $169.82 |
AmeriHealth Setting Professional Modifier None Typical Low $83.18 Median $162.18 Typical High $380.19 | Professional | None | $83.18 | $162.18 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $144.54 | Professional | None | $57.54 | $89.13 | $144.54 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $51.29 Typical High $181.97 | Professional | None | $30.90 | $51.29 | $181.97 |
Horizon BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $186.21 | Professional | None | $114.82 | $114.82 | $186.21 |
United Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $147.91 | Professional | None | $75.86 | $89.13 | $147.91 |
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 $95.50 Median $112.20 Typical High $123.03 | Professional | 25 · Same-day visit | $95.50 | $112.20 | $123.03 |
Where New Jersey sits
The same service costs 2.8 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
$91.20
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.