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 $5.89 Median $5.89 Typical High $6.76 | Facility | None | $5.89 | $5.89 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $13.80 | Professional | None | $5.89 | $5.89 | $13.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.95 Median $2.95 Typical High $6.92 | Professional | 52 · Reduced service | $2.95 | $2.95 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.17 Typical High $2.75 | Professional | 53 · Discontinued | $1.17 | $1.17 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $2.04 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $1.35 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Emblem Health Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $27.54 | Professional | None | $21.88 | $27.54 | $27.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | None | $13.18 | $13.18 | $13.49 |
United Setting Professional Modifier None Typical Low $10.23 Median $11.75 Typical High $12.59 | Professional | None | $10.23 | $11.75 | $12.59 |
4 more rates 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 MV Typical Low $10.00 Median $10.00 Typical High $25.12 | Professional | MV | $10.00 | $10.00 | $25.12 |
AmeriHealth Setting Professional Modifier PL · Progressive lenses Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | PL · Progressive lenses | $10.00 | $10.00 | $10.00 |
AmeriHealth Setting Professional Modifier PM · Post mortem Typical Low $5.01 Median $5.01 Typical High $30.20 | Professional | PM · Post mortem | $5.01 | $5.01 | $30.20 |
AmeriHealth Setting Professional Modifier SV · Delivered, not used Typical Low $10.00 Median $10.00 Typical High $15.14 | Professional | SV · Delivered, not used | $10.00 | $10.00 | $15.14 |
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· 44th of 51
$10.96
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.