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 $20.89 Median $20.89 Typical High $23.99 | Facility | None | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $44.67 | Professional | None | $20.89 | $20.89 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $22.39 | Professional | 52 · Reduced service | $10.47 | $10.47 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $8.91 | Professional | 53 · Discontinued | $4.17 | $4.17 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $6.61 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $4.37 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | None | $77.62 | $97.72 | $97.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | None | $58.88 | $58.88 | $60.26 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $74.13 | Facility | None | $63.10 | $63.10 | $74.13 |
United Setting Professional Modifier None Typical Low $10.96 Median $38.90 Typical High $44.67 | Professional | None | $10.96 | $38.90 | $44.67 |
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 2.6 times more in Hawaii than in Utah. 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
$37.15
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.