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 $79.43 Median $104.71 Typical High $114.82 | Facility | None | $79.43 | $104.71 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $151.36 | Professional | None | $79.43 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $48.98 Typical High $56.23 | Professional | 52 · Reduced service | $39.81 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.79 Typical High $16.98 | Professional | 55 · Aftercare only | $11.75 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.77 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $9.77 | $11.48 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $158.49 | Professional | None | $125.89 | $147.91 | $158.49 |
AmeriHealth Setting Facility Modifier None Typical Low $173.78 Median $398.11 Typical High $758.58 | Facility | None | $173.78 | $398.11 | $758.58 |
AmeriHealth Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $263.03 | Professional | None | $109.65 | $109.65 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $165.96 | Professional | None | $70.79 | $100.00 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $57.54 Typical High $204.17 | Professional | None | $30.90 | $57.54 | $204.17 |
Horizon BCBS Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | None | $147.91 | $147.91 | $199.53 |
United Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $165.96 | Professional | None | $87.10 | $102.33 | $165.96 |
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 $125.89 Median $144.54 Typical High $147.91 | Professional | 25 · Same-day visit | $125.89 | $144.54 | $147.91 |
Where New Jersey sits
The same service costs 2.7 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· 40th of 51
$110
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.