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 $19.95 Median $19.95 Typical High $22.91 | Facility | None | $19.95 | $19.95 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $41.69 | Professional | None | $19.95 | $19.95 | $41.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $10.00 Typical High $20.89 | Professional | 52 · Reduced service | $10.00 | $10.00 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $8.32 | Professional | 53 · Discontinued | $3.98 | $3.98 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $6.17 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $3.98 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | None | $74.13 | $93.33 | $93.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | None | $56.23 | $56.23 | $57.54 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $70.79 | Facility | None | $60.26 | $60.26 | $70.79 |
United Setting Professional Modifier None Typical Low $10.96 Median $37.15 Typical High $42.66 | Professional | None | $10.96 | $37.15 | $42.66 |
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 3.0 times more in Hawaii 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
$35.48
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.