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 $380.19 Median $512.86 Typical High $549.54 | Professional | None | $380.19 | $512.86 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $4,466.84 | Facility | None | $1,230.27 | $2,041.74 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $7,762.47 | Facility | None | $1,584.89 | $3,019.95 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $1,000.00 | Professional | None | $416.87 | $489.78 | $1,000.00 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $1,288.25 | Professional | None | $331.13 | $436.52 | $1,288.25 |
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 $190.55 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $190.55 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $75.86 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $263.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $56.23 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.02 | $51.29 | $51.29 |
Where New Jersey sits
The same service costs 8.1 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· 19th of 51
$871
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.