How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,047.13 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $3,235.94 Median $14,791.08 Typical High $26,915.35 | Facility | None | $3,235.94 | $14,791.08 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,698.24 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $13,182.57 Typical High $61,659.50 | Facility | None | $7,079.46 | $13,182.57 | $61,659.50 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,584.89 | $1,819.70 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $8,317.64 Typical High $18,197.01 | Facility | None | $1,905.46 | $8,317.64 | $18,197.01 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,584.89 | Professional | None | $891.25 | $1,047.13 | $1,584.89 |
5 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Where New Jersey sits
The same service costs 6.9 times more in Arkansas than in Kentucky. 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· 40th of 51
$1,585
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.