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 $28.84 Median $28.84 Typical High $33.11 | Facility | None | $28.84 | $28.84 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $69.18 | Professional | None | $28.84 | $28.84 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $34.67 | Professional | 52 · Reduced service | $14.45 | $14.45 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $13.80 | Professional | 53 · Discontinued | $5.75 | $5.75 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $10.23 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $6.61 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $6.61 |
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 $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | None | $107.15 | $134.90 | $134.90 |
Horizon BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | None | $81.28 | $81.28 | $83.18 |
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 $53.70 Typical High $61.66 | Professional | None | $10.96 | $53.70 | $61.66 |
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 3.2 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
$51.29
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.