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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None (both parts) Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | None (both parts) | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | 26 · Professional part | $20.89 | $21.88 | $21.88 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | TC · Technical part | $36.31 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Facility | None | $79.43 | $79.43 | $95.50 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $83.18 | $83.18 | $83.18 |
Horizon BCBS Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $173.78 | Facility | None | $83.18 | $138.04 | $173.78 |
Horizon BCBS Setting Professional Modifier None (both parts) Typical Low $51.29 Median $58.88 Typical High $77.62 | Professional | None (both parts) | $51.29 | $58.88 | $77.62 |
Horizon BCBS Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $20.89 Typical High $28.18 | Professional | 26 · Professional part | $18.20 | $20.89 | $28.18 |
Horizon BCBS Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $38.02 Typical High $50.12 | Professional | TC · Technical part | $33.11 | $38.02 | $50.12 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $154.88 | Facility | None | $72.44 | $72.44 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $52.48 Median $61.66 Typical High $112.20 | Professional | None (both parts) | $52.48 | $61.66 | $112.20 |
United Setting Professional Modifier 26 · Professional part Typical Low $18.62 Median $21.88 Typical High $39.81 | Professional | 26 · Professional part | $18.62 | $21.88 | $39.81 |
United Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $40.74 Typical High $75.86 | Professional | TC · Technical part | $33.88 | $40.74 | $75.86 |
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 $28.84 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $28.84 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | 54 · Surgery only | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.51 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $6.17 |
Where New Jersey sits
The same service costs 3.3 times more in Nebraska 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· 20th of 51
$58.88
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.