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 $15.85 Median $15.85 Typical High $17.78 | Facility | None | $15.85 | $15.85 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $32.36 | Professional | None | $15.85 | $15.85 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $7.76 Typical High $16.22 | Professional | 52 · Reduced service | $7.76 | $7.76 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $6.46 | Professional | 53 · Discontinued | $3.16 | $3.16 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.34 Typical High $4.90 | Professional | 55 · Aftercare only | $2.34 | $2.34 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $3.24 |
AmeriHealth Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $25.12 | Professional | None | $19.95 | $19.95 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Emblem Health Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $72.44 | Professional | None | $58.88 | $72.44 | $72.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | None | $44.67 | $44.67 | $45.71 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Facility | None | $46.77 | $46.77 | $54.95 |
United Setting Professional Modifier None Typical Low $10.96 Median $28.84 Typical High $33.11 | Professional | None | $10.96 | $28.84 | $33.11 |
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 |
|---|---|---|---|---|---|
AmeriHealth Setting Professional Modifier GX · Voluntary liability notice Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | GX · Voluntary liability notice | $12.59 | $12.88 | $12.88 |
Where New Jersey sits
The same service costs 3.2 times more in Montana than in Indiana. 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
$28.18
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.