How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $16.22 Median $16.22 Typical High $17.38 | Facility | None | $16.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $21.38 | Professional | None | $16.22 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $8.13 Typical High $9.77 | Professional | 52 · Reduced service | $8.13 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.89 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.95 |
AmeriHealth Setting Facility Modifier None Typical Low $208.93 Median $467.74 Typical High $1,258.93 | Facility | None | $208.93 | $467.74 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $44.67 | Facility | None | $30.20 | $34.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Emblem Health Setting Professional Modifier None Typical Low $29.51 Median $58.88 Typical High $58.88 | Professional | None | $29.51 | $58.88 | $58.88 |
Horizon BCBS Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $24.55 Typical High $43.65 | Professional | None | $20.42 | $24.55 | $43.65 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | KX · Policy requirements met | $37.15 | $37.15 | $37.15 |
Where New Jersey sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 49th of 51
$25.70
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.