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 $13.18 Median $13.49 Typical High $13.49 | Facility | None | $13.18 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $13.49 Typical High $14.79 | Professional | None | $12.59 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.31 Median $6.76 Typical High $7.41 | Professional | 52 · Reduced service | $6.31 | $6.76 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.69 Typical High $3.02 | Professional | 53 · Discontinued | $2.51 | $2.69 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $2.04 Typical High $2.24 | Professional | 55 · Aftercare only | $1.86 | $2.04 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.35 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.26 | $1.35 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
Emblem Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | None | $63.10 | $63.10 | $72.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $58.88 | Professional | None | $22.39 | $22.39 | $58.88 |
United Setting Professional Modifier None Typical Low $12.30 Median $16.22 Typical High $25.12 | Professional | None | $12.30 | $16.22 | $25.12 |
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 $3.47 Median $19.50 Typical High $22.39 | Professional | RR · Rental | $3.47 | $19.50 | $22.39 |
Where New Jersey sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 33rd of 51
$20.42
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.