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 $24.55 Median $24.55 Typical High $28.18 | Facility | None | $24.55 | $24.55 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $48.98 | Professional | None | $24.55 | $24.55 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $23.99 | Professional | 52 · Reduced service | $12.30 | $12.30 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $9.77 | Professional | 53 · Discontinued | $4.90 | $4.90 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $7.24 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $4.79 |
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 $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Emblem Health Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $114.82 | Professional | None | $91.20 | $114.82 | $114.82 |
Horizon BCBS Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | None | $69.18 | $69.18 | $70.79 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $89.13 | Facility | None | $75.86 | $75.86 | $89.13 |
United Setting Professional Modifier None Typical Low $12.88 Median $45.71 Typical High $52.48 | Professional | None | $12.88 | $45.71 | $52.48 |
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 Indiana. 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· 33rd of 51
$43.65
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.