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 $48.98 Median $50.12 Typical High $50.12 | Facility | None | $48.98 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $50.12 Typical High $56.23 | Professional | None | $48.98 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $25.12 Typical High $28.18 | Professional | 52 · Reduced service | $23.44 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.00 Typical High $11.22 | Professional | 53 · Discontinued | $9.33 | $10.00 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.59 Typical High $8.51 | Professional | 55 · Aftercare only | $7.08 | $7.59 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.01 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.68 | $5.01 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | None | $27.54 | $27.54 | $38.02 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $125.89 | Professional | None | $109.65 | $109.65 | $125.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $223.87 | Professional | None | $83.18 | $83.18 | $223.87 |
United Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $95.50 | Professional | None | $45.71 | $60.26 | $95.50 |
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 $13.80 Median $83.18 Typical High $83.18 | Professional | RR · Rental | $13.80 | $83.18 | $83.18 |
Where New Jersey sits
The same service costs 49.0 times more in North Dakota than in Hawaii. 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· 24th of 51
$56.23
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.