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 $37.15 Median $37.15 Typical High $42.66 | Facility | None | $37.15 | $37.15 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $74.13 | Professional | None | $37.15 | $37.15 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $18.62 Typical High $37.15 | Professional | 52 · Reduced service | $18.62 | $18.62 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $14.79 | Professional | 53 · Discontinued | $7.41 | $7.41 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $10.96 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $7.08 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | None | $138.04 | $173.78 | $173.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | None | $104.71 | $104.71 | $107.15 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $138.04 | Facility | None | $117.49 | $117.49 | $138.04 |
United Setting Professional Modifier None Typical Low $12.88 Median $69.18 Typical High $79.43 | Professional | None | $12.88 | $69.18 | $79.43 |
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 2.6 times more in Hawaii 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· 33rd of 51
$66.07
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.