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 $33.11 Median $33.11 Typical High $46.77 | Facility | None | $33.11 | $33.11 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $37.15 Typical High $46.77 | Facility | None | $33.11 | $37.15 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | None | $33.11 | $33.11 | $37.15 |
Emblem Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | None | $33.11 | $33.11 | $40.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $30.90 Median $69.18 Typical High $117.49 | Facility | None | $30.90 | $69.18 | $117.49 |
Horizon BCBS Setting Professional Modifier None Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | None | $30.90 | $31.62 | $31.62 |
United Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | None | $30.90 | $34.67 | $34.67 |
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 $33.11 Median $37.15 Typical High $37.15 | Professional | JW · Drug discarded | $33.11 | $37.15 | $37.15 |
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· 31st of 51
$33.11
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.