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 $1,513.56 Median $2,238.72 Typical High $2,344.23 | Professional | None | $1,513.56 | $2,238.72 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $5,011.87 | Facility | None | $1,862.09 | $2,884.03 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,981.07 Typical High $11,748.98 | Facility | None | $2,238.72 | $3,981.07 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $4,677.35 | Professional | None | $1,905.46 | $2,187.76 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $5,888.44 | Professional | None | $1,698.24 | $2,187.76 | $5,888.44 |
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 $758.58 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $758.58 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $302.00 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,071.52 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $223.87 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $151.36 | $223.87 | $223.87 |
Where New Jersey sits
The same service costs 15.8 times more in Wisconsin 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· 30th of 51
$2,399
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.