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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $851.14 | Professional | None | $776.25 | $831.76 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $8,912.51 | Facility | None | $1,995.26 | $4,897.79 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | None | $933.25 | $933.25 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | None | $891.25 | $954.99 | $954.99 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $4,365.16 Typical High $19,952.62 | Facility | None | $2,344.23 | $4,365.16 | $19,952.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,202.26 | Professional | None | $741.31 | $870.96 | $1,202.26 |
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 $501.19 Median $660.69 Typical High $870.96 | Professional | None | $501.19 | $660.69 | $870.96 |
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 $389.05 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $588.84 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $83.18 |
Where New Jersey sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 43rd of 51
$832
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.