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 $575.44 Median $7,244.36 Typical High $19,054.61 | Facility | None | $575.44 | $7,244.36 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $741.31 | Professional | None | $489.78 | $602.56 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,388.44 Typical High $6,456.54 | Facility | None | $1,995.26 | $3,388.44 | $6,456.54 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,888.44 Typical High $14,125.38 | Facility | None | $3,235.94 | $5,888.44 | $14,125.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,258.93 | Professional | None | $501.19 | $588.84 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,548.82 | Professional | None | $457.09 | $588.84 | $1,548.82 |
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 $245.47 Median $302.00 Typical High $309.03 | Professional | 52 · Reduced service | $245.47 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $97.72 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $346.74 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $61.66 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $61.66 |
Where New Jersey sits
The same service costs 10.2 times more in Texas 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· 26th of 51
$1,349
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.