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 $4,466.84 Median $9,332.54 Typical High $14,125.38 | Facility | None | $4,466.84 | $9,332.54 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $501.19 | Professional | None | $354.81 | $467.74 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $25,118.86 Typical High $39,810.72 | Facility | None | $1,995.26 | $25,118.86 | $39,810.72 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $19,054.61 Median $34,673.69 Typical High $91,201.08 | Facility | None | $19,054.61 | $34,673.69 | $91,201.08 |
Horizon BCBS Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $954.99 | Professional | None | $380.19 | $446.68 | $954.99 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $9,332.54 Typical High $23,442.29 | Facility | None | $1,905.46 | $9,332.54 | $23,442.29 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $1,202.26 | Professional | None | $346.74 | $446.68 | $1,202.26 |
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 $177.83 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $177.83 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $35.48 | $46.77 | $46.77 |
Where New Jersey sits
The same service costs 57.5 times more in Arkansas 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· 25th of 51
$1,175
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.