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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | None | $208.93 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $3,235.94 | Facility | None | $1,548.82 | $2,344.23 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $398.11 Typical High $398.11 | Professional | None | $199.53 | $398.11 | $398.11 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $7,413.10 | Facility | None | $1,584.89 | $2,818.38 | $7,413.10 |
Horizon BCBS Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $537.03 | Professional | None | $190.55 | $229.09 | $537.03 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $977.24 | Professional | None | $190.55 | $302.00 | $977.24 |
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 $100.00 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $100.00 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $29.51 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $31.62 |
Where New Jersey sits
The same service costs 19.5 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· 25th of 51
$363
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.