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 $7.41 Median $7.59 Typical High $28.18 | Facility | None | $7.41 | $7.59 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.59 Typical High $10.47 | Professional | None | $7.41 | $7.59 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $3.80 Typical High $4.27 | Professional | 52 · Reduced service | $3.55 | $3.80 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.51 Typical High $1.70 | Professional | 53 · Discontinued | $1.48 | $1.51 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.12 Typical High $1.29 | Professional | 55 · Aftercare only | $1.07 | $1.12 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.76 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.72 | $0.76 | $0.85 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Emblem Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | None | $22.91 | $22.91 | $45.71 |
Horizon BCBS Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $27.54 | Professional | None | $12.59 | $12.59 | $27.54 |
United Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $14.45 | Professional | None | $6.92 | $9.12 | $14.45 |
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 $2.14 Median $12.02 Typical High $12.59 | Professional | RR · Rental | $2.14 | $12.02 | $12.59 |
Where New Jersey sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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
$12.30
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.