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 $27.54 Median $27.54 Typical High $31.62 | Facility | None | $27.54 | $27.54 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $57.54 | Professional | None | $27.54 | $27.54 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $13.80 Typical High $28.84 | Professional | 52 · Reduced service | $13.80 | $13.80 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $11.48 | Professional | 53 · Discontinued | $5.62 | $5.62 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $8.51 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $5.75 |
AmeriHealth Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | None | $102.33 | $128.82 | $128.82 |
Horizon BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Facility | None | $89.13 | $89.13 | $104.71 |
United Setting Professional Modifier None Typical Low $15.14 Median $51.29 Typical High $58.88 | Professional | None | $15.14 | $51.29 | $58.88 |
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 2.7 times more in Hawaii than in Utah. 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· 38th of 51
$50.12
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.