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 $97.72 Median $128.82 Typical High $131.83 | Facility | None | $97.72 | $128.82 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $177.83 | Professional | None | $97.72 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $48.98 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $14.45 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.77 | $11.48 | $13.18 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $181.97 | Professional | None | $147.91 | $173.78 | $181.97 |
AmeriHealth Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $281.84 | Professional | None | $109.65 | $169.82 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $190.55 | Professional | None | $85.11 | $114.82 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $67.61 Typical High $234.42 | Professional | None | $30.90 | $67.61 | $234.42 |
Horizon BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $229.09 | Professional | None | $169.82 | $169.82 | $229.09 |
United Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $194.98 | Professional | None | $102.33 | $114.82 | $194.98 |
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 $138.04 Median $173.78 Typical High $173.78 | Professional | 25 · Same-day visit | $138.04 | $173.78 | $173.78 |
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· 39th of 51
$129
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.