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 $26.30 Median $26.30 Typical High $30.20 | Facility | None | $26.30 | $26.30 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $58.88 | Professional | None | $26.30 | $26.30 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.18 Typical High $29.51 | Professional | 52 · Reduced service | $13.18 | $13.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $12.02 | Professional | 53 · Discontinued | $5.25 | $5.25 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $8.91 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $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 $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Emblem Health Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | None | $97.72 | $123.03 | $123.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | None | $74.13 | $74.13 | $75.86 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Facility | None | $102.33 | $102.33 | $120.23 |
United Setting Professional Modifier None Typical Low $10.96 Median $48.98 Typical High $56.23 | Professional | None | $10.96 | $48.98 | $56.23 |
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 3.5 times more in Hawaii than in New York. 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· 41st of 51
$46.77
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.