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 $25.70 Median $25.70 Typical High $29.51 | Facility | None | $25.70 | $25.70 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $53.70 | Professional | None | $25.70 | $25.70 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $12.88 Typical High $26.92 | Professional | 52 · Reduced service | $12.88 | $12.88 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $10.72 | Professional | 53 · Discontinued | $5.13 | $5.13 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $7.94 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $5.37 |
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 $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | None | $95.50 | $120.23 | $120.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | None | $72.44 | $72.44 | $74.13 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Facility | None | $77.62 | $77.62 | $91.20 |
United Setting Professional Modifier None Typical Low $10.96 Median $47.86 Typical High $54.95 | Professional | None | $10.96 | $47.86 | $54.95 |
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 2.7 times more in Hawaii than in Alabama. 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· 31st of 51
$45.71
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.