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 $125.89 Median $144.54 Typical High $144.54 | Facility | None | $125.89 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $147.91 | Professional | None | $125.89 | $144.54 | $147.91 |
Aetna Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $109.65 Typical High $112.20 | Professional | UE · Used equipment | $95.50 | $109.65 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | None | $151.36 | $151.36 | $177.83 |
Cigna Setting Professional Modifier RR · Rental Typical Low $15.14 Median $15.14 Typical High $17.78 | Professional | RR · Rental | $15.14 | $15.14 | $17.78 |
Cigna Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | UE · Used equipment | $114.82 | $114.82 | $114.82 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Horizon BCBS Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | None | $158.49 | $181.97 | $181.97 |
Horizon BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $18.20 Typical High $18.20 | Professional | RR · Rental | $15.85 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $269.15 | Professional | None | $109.65 | $131.83 | $269.15 |
United Setting Professional Modifier RR · Rental Typical Low $13.18 Median $13.80 Typical High $33.88 | Professional | RR · Rental | $13.18 | $13.80 | $33.88 |
United Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $97.72 Typical High $204.17 | Professional | UE · Used equipment | $85.11 | $97.72 | $204.17 |
4 more rates 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 52 · Reduced service Typical Low $63.10 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $63.10 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.84 Typical High $29.51 | Professional | 53 · Discontinued | $25.12 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.45 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.59 | $14.45 | $14.79 |
Where New Jersey sits
The same service costs 22.4 times more in Kansas than in Illinois. 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
$158
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.