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 $17.38 Median $17.38 Typical High $19.95 | Facility | None | $17.38 | $17.38 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $34.67 | Professional | None | $17.38 | $17.38 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $8.71 Typical High $17.38 | Professional | 52 · Reduced service | $8.71 | $8.71 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $6.76 | Professional | 53 · Discontinued | $3.47 | $3.47 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $5.01 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $3.39 |
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 $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Emblem Health Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $81.28 | Professional | None | $64.57 | $81.28 | $81.28 |
Horizon BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | None | $48.98 | $48.98 | $50.12 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $61.66 | Facility | None | $52.48 | $52.48 | $61.66 |
United Setting Professional Modifier None Typical Low $10.96 Median $32.36 Typical High $37.15 | Professional | None | $10.96 | $32.36 | $37.15 |
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 3.3 times more in Montana than in Missouri. 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
$30.90
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.