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 $537.03 Median $575.44 Typical High $575.44 | Professional | None | $537.03 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,456.54 Typical High $11,220.18 | Facility | None | $1,995.26 | $6,456.54 | $11,220.18 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $7,762.47 Typical High $27,542.29 | Facility | None | $4,073.80 | $7,762.47 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $831.76 | Professional | None | $489.78 | $562.34 | $831.76 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,818.38 | $6,918.31 |
United Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $724.44 | Professional | None | $389.05 | $467.74 | $724.44 |
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 $269.15 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $109.65 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $57.54 |
Where New Jersey sits
The same service costs 7.2 times more in Texas than in Pennsylvania. 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· 46th of 51
$537
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.