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 $28.18 Median $28.18 Typical High $32.36 | Facility | None | $28.18 | $28.18 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $58.88 | Professional | None | $28.18 | $28.18 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.13 Typical High $29.51 | Professional | 52 · Reduced service | $14.13 | $14.13 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $11.75 | Professional | 53 · Discontinued | $5.62 | $5.62 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $8.91 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $5.89 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | None | $104.71 | $131.83 | $131.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | None | $79.43 | $79.43 | $81.28 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Facility | None | $87.10 | $87.10 | $102.33 |
United Setting Professional Modifier None Typical Low $10.96 Median $52.48 Typical High $60.26 | Professional | None | $10.96 | $52.48 | $60.26 |
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 Nebraska. 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
$50.12
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.