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 $10,471.29 Typical High $14,791.08 | Facility | None | $4,466.84 | $10,471.29 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $758.58 | Professional | None | $501.19 | $707.95 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $19,498.45 Typical High $33,884.42 | Facility | None | $1,995.26 | $19,498.45 | $33,884.42 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $14,454.40 Typical High $72,443.60 | Facility | None | $7,943.28 | $14,454.40 | $72,443.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,258.93 | Professional | None | $602.56 | $691.83 | $1,258.93 |
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 $426.58 Median $602.56 Typical High $1,778.28 | Professional | None | $426.58 | $602.56 | $1,778.28 |
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 $234.42 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $93.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $323.59 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $70.79 | $70.79 |
Where New Jersey sits
The same service costs 27.5 times more in Oklahoma than in New York. 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· 25th of 51
$1,380
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.