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 $346.74 Median $371.54 Typical High $398.11 | Professional | None | $346.74 | $371.54 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $9,772.37 Typical High $17,378.01 | Facility | None | $1,995.26 | $9,772.37 | $17,378.01 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $602.56 | Professional | None | $380.19 | $602.56 | $602.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,912.51 Typical High $38,904.51 | Facility | None | $5,011.87 | $8,912.51 | $38,904.51 |
Horizon BCBS Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $912.01 | Professional | None | $316.23 | $363.08 | $912.01 |
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 $295.12 Median $478.63 Typical High $954.99 | Professional | None | $295.12 | $478.63 | $954.99 |
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 $173.78 Median $186.21 Typical High $190.55 | Professional | 52 · Reduced service | $173.78 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $69.18 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $288.40 | Professional | 54 · Surgery only | $263.03 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $37.15 Typical High $38.02 | Professional | 56 · Pre-op care only | $34.67 | $37.15 | $38.02 |
Where New Jersey sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 22nd of 51
$933
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.