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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,659.59 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,187.76 Typical High $11,220.18 | Facility | None | $1,071.52 | $2,187.76 | $11,220.18 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,513.56 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,584.89 | $3,467.37 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,479.11 | $4,073.80 |
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 $630.96 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $630.96 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $165.96 |
Where New Jersey sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 31st of 51
$1,585
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.