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 $16.22 Median $16.60 Typical High $16.60 | Facility | None | $16.22 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $16.60 Typical High $18.20 | Professional | None | $15.85 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.32 Typical High $9.12 | Professional | 52 · Reduced service | $7.76 | $8.32 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.31 Typical High $3.72 | Professional | 53 · Discontinued | $3.09 | $3.31 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.45 Typical High $2.75 | Professional | 55 · Aftercare only | $2.40 | $2.45 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.66 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.55 | $1.66 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Emblem Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $29.51 | Professional | None | $25.70 | $25.70 | $29.51 |
Horizon BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $70.79 | Professional | None | $27.54 | $27.54 | $70.79 |
United Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $30.90 | Professional | None | $15.14 | $19.95 | $30.90 |
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 |
|---|---|---|---|---|---|
Horizon BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $23.99 Typical High $27.54 | Professional | RR · Rental | $4.27 | $23.99 | $27.54 |
Where New Jersey sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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· 36th of 51
$19.95
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.