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 $70.79 Median $70.79 Typical High $104.71 | Facility | None | $70.79 | $70.79 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $134.90 | Professional | None | $70.79 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $35.48 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $10.47 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.08 | $9.12 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $134.90 | Professional | None | $97.72 | $109.65 | $134.90 |
AmeriHealth Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $407.38 | Professional | None | $87.10 | $169.82 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $151.36 | Professional | None | $61.66 | $91.20 | $151.36 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $51.29 Typical High $190.55 | Professional | None | $30.90 | $51.29 | $190.55 |
Horizon BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $194.98 | Professional | None | $120.23 | $120.23 | $194.98 |
United Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $151.36 | Professional | None | $75.86 | $87.10 | $151.36 |
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 $117.49 Median $138.04 Typical High $177.83 | Professional | 25 · Same-day visit | $117.49 | $138.04 | $177.83 |
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· 47th 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.