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 $30.90 Median $31.62 Typical High $31.62 | Facility | None | $30.90 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $34.67 | Professional | None | $29.51 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.85 Typical High $17.38 | Professional | 52 · Reduced service | $14.79 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.31 Typical High $6.92 | Professional | 53 · Discontinued | $5.89 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.68 Typical High $5.25 | Professional | 55 · Aftercare only | $4.37 | $4.68 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.16 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.95 | $3.16 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Emblem Health Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | None | $66.07 | $66.07 | $75.86 |
Horizon BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $134.90 | Professional | None | $52.48 | $52.48 | $134.90 |
United Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $58.88 | Professional | None | $28.18 | $38.02 | $58.88 |
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 $7.94 Median $50.12 Typical High $52.48 | Professional | RR · Rental | $7.94 | $50.12 | $52.48 |
Where New Jersey sits
The same service costs 4.1 times more in Kansas 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· 42nd 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.