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 $4,570.88 Median $9,120.11 Typical High $19,498.45 | Facility | None | $4,570.88 | $9,120.11 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $575.44 | Professional | None | $54.95 | $57.54 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $8,709.64 Typical High $15,848.93 | Facility | None | $1,995.26 | $8,709.64 | $15,848.93 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Horizon BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $12,302.69 Typical High $33,884.42 | Facility | None | $6,606.93 | $12,302.69 | $33,884.42 |
Horizon BCBS Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $512.86 | Professional | None | $47.86 | $56.23 | $512.86 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,495.41 Typical High $13,803.84 | Facility | None | $1,659.59 | $5,495.41 | $13,803.84 |
United Setting Professional Modifier None Typical Low $48.98 Median $154.88 Typical High $457.09 | Professional | None | $48.98 | $154.88 | $457.09 |
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 $27.54 Median $28.84 Typical High $83.18 | Professional | 52 · Reduced service | $27.54 | $28.84 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.48 Typical High $33.88 | Professional | 53 · Discontinued | $10.96 | $11.48 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $43.65 Typical High $125.89 | Professional | 54 · Surgery only | $40.74 | $43.65 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.71 Typical High $25.12 | Professional | 55 · Aftercare only | $8.13 | $8.71 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.50 | $5.75 | $16.60 |
Where New Jersey sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 27th of 51
$933
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.