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 $380.19 Median $398.11 Typical High $660.69 | Professional | None | $380.19 | $398.11 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,760.83 Typical High $11,748.98 | Facility | None | $1,995.26 | $6,760.83 | $11,748.98 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,047.13 | Professional | None | $436.52 | $436.52 | $1,047.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $3,162.28 Typical High $38,904.51 | Facility | None | $1,737.80 | $3,162.28 | $38,904.51 |
Horizon BCBS Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $1,148.15 | Professional | None | $338.84 | $389.05 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,318.26 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $1,047.13 | Professional | None | $302.00 | $398.11 | $1,047.13 |
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 $190.55 Median $199.53 Typical High $309.03 | Professional | 52 · Reduced service | $190.55 | $199.53 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $123.03 | Professional | 53 · Discontinued | $75.86 | $79.43 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $457.09 | Professional | 54 · Surgery only | $281.84 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $91.20 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $61.66 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $61.66 |
Where New Jersey sits
The same service costs 14.8 times more in Texas 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· 32nd of 51
$955
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.