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 $36.31 Median $36.31 Typical High $54.95 | Facility | None | $36.31 | $36.31 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $41.69 Typical High $56.23 | Facility | None | $36.31 | $41.69 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | None | $36.31 | $36.31 | $41.69 |
Emblem Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | None | $38.02 | $38.02 | $42.66 |
Horizon BCBS Setting Facility Modifier None Typical Low $36.31 Median $81.28 Typical High $134.90 | Facility | None | $36.31 | $81.28 | $134.90 |
Horizon BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | None | $36.31 | $40.74 | $40.74 |
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 JW · Drug discarded Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | JW · Drug discarded | $43.65 | $43.65 | $43.65 |
Where New Jersey sits
Rates are fairly even across states for this service. 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· 38th of 51
$36.31
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.