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 $22.39 Median $22.39 Typical High $25.70 | Facility | None | $22.39 | $22.39 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $44.67 | Professional | None | $22.39 | $22.39 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $11.22 Typical High $22.39 | Professional | 52 · Reduced service | $11.22 | $11.22 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $8.91 | Professional | 53 · Discontinued | $4.47 | $4.47 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $6.61 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $4.47 |
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 $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $104.71 | Professional | None | $74.13 | $104.71 | $104.71 |
Horizon BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $64.57 | Professional | None | $63.10 | $63.10 | $64.57 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $79.43 | Facility | None | $67.61 | $67.61 | $79.43 |
United Setting Professional Modifier None Typical Low $10.96 Median $41.69 Typical High $47.86 | Professional | None | $10.96 | $41.69 | $47.86 |
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 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· 32nd of 51
$39.81
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.