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 $4,570.88 Median $8,511.38 Typical High $11,748.98 | Facility | None | $4,570.88 | $8,511.38 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $6,165.95 Median $11,748.98 Typical High $12,022.64 | Professional | None | $6,165.95 | $11,748.98 | $12,022.64 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $11,220.18 Typical High $19,498.45 | Facility | None | $1,995.26 | $11,220.18 | $19,498.45 |
Emblem Health Setting Professional Modifier None Typical Low $9,772.37 Median $16,982.44 Typical High $16,982.44 | Professional | None | $9,772.37 | $16,982.44 | $16,982.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,709.64 Typical High $43,651.58 | Facility | None | $4,786.30 | $8,709.64 | $43,651.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $11,748.98 Median $12,302.69 Typical High $22,908.68 | Professional | None | $11,748.98 | $12,302.69 | $22,908.68 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,495.41 Typical High $13,803.84 | Facility | None | $1,659.59 | $5,495.41 | $13,803.84 |
United Setting Professional Modifier None Typical Low $954.99 Median $10,471.29 Typical High $31,622.78 | Professional | None | $954.99 | $10,471.29 | $31,622.78 |
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 $3,019.95 Median $5,888.44 Typical High $5,888.44 | Professional | 52 · Reduced service | $3,019.95 | $5,888.44 | $5,888.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $2,344.23 Typical High $2,344.23 | Professional | 53 · Discontinued | $1,230.27 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,466.84 Median $8,709.64 Typical High $8,709.64 | Professional | 54 · Surgery only | $4,466.84 | $8,709.64 | $8,709.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $912.01 Median $1,778.28 Typical High $1,778.28 | Professional | 55 · Aftercare only | $912.01 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $616.60 Median $1,174.90 Typical High $1,174.90 | Professional | 56 · Pre-op care only | $616.60 | $1,174.90 | $1,174.90 |
Where New Jersey sits
The same service costs 16.6 times more in Indiana than in Nebraska. 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· 21st of 51
$10,965
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.