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 $70.79 Median $97.72 Typical High $97.72 | Facility | None | $70.79 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $131.83 | Professional | None | $70.79 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $44.67 Typical High $48.98 | Professional | 52 · Reduced service | $35.48 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $10.47 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.91 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.08 | $8.91 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | None | $125.89 | $131.83 | $131.83 |
AmeriHealth Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $380.19 | Professional | None | $83.18 | $128.82 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $158.49 | Professional | None | $87.10 | $102.33 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $181.97 | Professional | None | $30.90 | $44.67 | $181.97 |
Horizon BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $173.78 | Professional | None | $114.82 | $114.82 | $173.78 |
United Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $147.91 | Professional | None | $69.18 | $79.43 | $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 $120.23 | Professional | 25 · Same-day visit | $95.50 | $112.20 | $120.23 |
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· 37th of 51
$97.72
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.