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 $72.44 Median $74.13 Typical High $74.13 | Facility | None | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $83.18 | Professional | None | $72.44 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $34.67 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $13.80 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.22 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | None | $251.19 | $251.19 | $288.40 |
Horizon BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $323.59 | Professional | None | $123.03 | $123.03 | $323.59 |
United Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $141.25 | Professional | None | $67.61 | $89.13 | $141.25 |
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 $19.05 Median $107.15 Typical High $123.03 | Professional | RR · Rental | $19.05 | $107.15 | $123.03 |
Where New Jersey sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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
$83.18
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.