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 $52.48 Median $57.54 Typical High $85.11 | Facility | None | $52.48 | $57.54 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $114.82 | Professional | None | $52.48 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $38.02 Typical High $41.69 | Professional | 52 · Reduced service | $26.30 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $11.22 Typical High $12.59 | Professional | 55 · Aftercare only | $7.94 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.59 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.25 | $7.59 | $8.51 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
AmeriHealth Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $281.84 | Professional | None | $77.62 | $117.49 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $123.03 | Professional | None | $48.98 | $75.86 | $123.03 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $42.66 Typical High $154.88 | Professional | None | $30.90 | $42.66 | $154.88 |
Horizon BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $151.36 | Professional | None | $100.00 | $100.00 | $151.36 |
United Setting Professional Modifier None Typical Low $52.48 Median $64.57 Typical High $125.89 | Professional | None | $52.48 | $64.57 | $125.89 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 25 · Same-day visit | $114.82 | $114.82 | $114.82 |
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
$75.86
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.