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 $30.90 Median $30.90 Typical High $35.48 | Facility | None | $30.90 | $30.90 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $77.62 | Professional | None | $30.90 | $30.90 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $38.02 | Professional | 52 · Reduced service | $15.49 | $15.49 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $15.14 | Professional | 53 · Discontinued | $6.17 | $6.17 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $11.48 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $7.59 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | None | $114.82 | $144.54 | $144.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | None | $87.10 | $87.10 | $89.13 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $147.91 | Facility | None | $123.03 | $123.03 | $147.91 |
United Setting Professional Modifier None Typical Low $15.14 Median $57.54 Typical High $66.07 | Professional | None | $15.14 | $57.54 | $66.07 |
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 4.2 times more in Hawaii than in New York. 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· 43rd 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.