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 $23.44 Median $23.44 Typical High $26.92 | Facility | None | $23.44 | $23.44 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $46.77 | Professional | None | $23.44 | $23.44 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $11.75 Typical High $22.91 | Professional | 52 · Reduced service | $11.75 | $11.75 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $9.12 | Professional | 53 · Discontinued | $4.68 | $4.68 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $6.61 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $4.37 |
AmeriHealth Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $39.81 | Professional | None | $34.67 | $34.67 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Emblem Health Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | None | $87.10 | $109.65 | $109.65 |
Horizon BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Facility | None | $70.79 | $70.79 | $83.18 |
United Setting Professional Modifier None Typical Low $12.88 Median $43.65 Typical High $50.12 | Professional | None | $12.88 | $43.65 | $50.12 |
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 2.8 times more in Montana than in Ohio. 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· 34th of 51
$42.66
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.