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 $31.62 Median $31.62 Typical High $36.31 | Facility | None | $31.62 | $31.62 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $67.61 | Professional | None | $31.62 | $31.62 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $33.11 | Professional | 52 · Reduced service | $15.85 | $15.85 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $13.49 | Professional | 53 · Discontinued | $6.31 | $6.31 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $10.00 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $6.76 |
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 $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Emblem Health Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | None | $117.49 | $147.91 | $147.91 |
Horizon BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | None | $89.13 | $89.13 | $91.20 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $131.83 | Facility | None | $112.20 | $112.20 | $131.83 |
United Setting Professional Modifier None Typical Low $15.14 Median $58.88 Typical High $67.61 | Professional | None | $15.14 | $58.88 | $67.61 |
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 2.5 times more in Montana than in Missouri. 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· 41st of 51
$56.23
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.