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 $4,466.84 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $602.56 | Professional | None | $467.74 | $588.84 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $25,703.96 Typical High $40,738.03 | Facility | None | $1,995.26 | $25,703.96 | $40,738.03 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $645.65 | Professional | None | $467.74 | $645.65 | $645.65 |
Horizon BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $19,952.62 Typical High $83,176.38 | Facility | None | $10,964.78 | $19,952.62 | $83,176.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $1,202.26 | Professional | None | $501.19 | $575.44 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $9,332.54 Typical High $23,442.29 | Facility | None | $1,905.46 | $9,332.54 | $23,442.29 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,513.56 | Professional | None | $446.68 | $575.44 | $1,513.56 |
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 $229.09 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $331.13 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $58.88 |
Where New Jersey sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 20th of 51
$1,413
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.