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 $0.20 Median $0.20 Typical High $0.31 | Facility | None | $0.20 | $0.20 | $0.31 |
Aetna Setting Professional Modifier None Typical Low $0.17 Median $0.31 Typical High $0.31 | Professional | None | $0.17 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.11 Median $0.16 Typical High $0.16 | Professional | 52 · Reduced service | $0.11 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | 53 · Discontinued | $0.04 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.03 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.02 | $0.03 | $0.03 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
AmeriHealth Setting Facility Modifier None Typical Low $239.88 Median $489.78 Typical High $933.25 | Facility | None | $239.88 | $489.78 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Emblem Health Setting Professional Modifier None Typical Low $0.55 Median $0.83 Typical High $0.83 | Professional | None | $0.55 | $0.83 | $0.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $6,456.54 | Facility | None | $5,888.44 | $5,888.44 | $6,456.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | None | $0.98 | $0.98 | $0.98 |
United Setting Professional Modifier None Typical Low $0.27 Median $0.33 Typical High $0.39 | Professional | None | $0.27 | $0.33 | $0.39 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.17 Typical High $0.17 | Professional | RR · Rental | $0.03 | $0.17 | $0.17 |
Where New Jersey sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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
$0.31
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.