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 $26.92 Median $26.92 Typical High $30.20 | Facility | None | $26.92 | $26.92 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $52.48 | Professional | None | $26.92 | $26.92 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.18 Typical High $25.70 | Professional | 52 · Reduced service | $13.18 | $13.18 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $10.47 | Professional | 53 · Discontinued | $5.37 | $5.37 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $7.76 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $5.13 |
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 $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | None | $100.00 | $123.03 | $123.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | None | $75.86 | $75.86 | $77.62 |
United Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Facility | None | $81.28 | $81.28 | $95.50 |
United Setting Professional Modifier None Typical Low $12.88 Median $48.98 Typical High $56.23 | Professional | None | $12.88 | $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 2.9 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· 31st of 51
$47.86
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.