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 $39.81 Median $39.81 Typical High $45.71 | Facility | None | $39.81 | $39.81 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $89.13 | Professional | None | $39.81 | $39.81 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $19.95 Typical High $44.67 | Professional | 52 · Reduced service | $19.95 | $19.95 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $17.78 | Professional | 53 · Discontinued | $7.94 | $7.94 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $13.49 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $8.91 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $8.91 |
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 $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | None | $147.91 | $186.21 | $186.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | None | $112.20 | $112.20 | $114.82 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $173.78 | Facility | None | $147.91 | $147.91 | $173.78 |
United Setting Professional Modifier None Typical Low $15.14 Median $74.13 Typical High $85.11 | Professional | None | $15.14 | $74.13 | $85.11 |
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 2.9 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· 44th of 51
$70.79
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.