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 $30.20 Median $30.20 Typical High $34.67 | Facility | None | $30.20 | $30.20 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | None | $30.20 | $30.20 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.14 Typical High $29.51 | Professional | 52 · Reduced service | $15.14 | $15.14 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $11.75 | Professional | 53 · Discontinued | $6.03 | $6.03 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $8.91 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $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 $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $138.04 | Professional | None | $100.00 | $138.04 | $138.04 |
Horizon BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | None | $85.11 | $85.11 | $87.10 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $109.65 | Facility | None | $93.33 | $93.33 | $109.65 |
United Setting Professional Modifier None Typical Low $15.14 Median $56.23 Typical High $63.10 | Professional | None | $15.14 | $56.23 | $63.10 |
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 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
$53.70
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.