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 $18.20 Median $18.62 Typical High $18.62 | Facility | None | $18.20 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $20.89 | Professional | None | $17.38 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $9.33 Typical High $10.23 | Professional | 52 · Reduced service | $8.71 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.72 Typical High $4.17 | Professional | 53 · Discontinued | $3.47 | $3.72 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.82 Typical High $3.09 | Professional | 55 · Aftercare only | $2.57 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.86 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.74 | $1.86 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Emblem Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | None | $51.29 | $51.29 | $58.88 |
Horizon BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $79.43 | Professional | None | $30.90 | $30.90 | $79.43 |
United Setting Professional Modifier None Typical Low $16.98 Median $22.39 Typical High $35.48 | Professional | None | $16.98 | $22.39 | $35.48 |
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 $4.79 Median $26.92 Typical High $30.90 | Professional | RR · Rental | $4.79 | $26.92 | $30.90 |
Where New Jersey sits
The same service costs 8.9 times more in North Dakota 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· 37th of 51
$30.90
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.