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 $512.86 Median $660.69 Typical High $707.95 | Professional | None | $512.86 | $660.69 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,862.09 | $2,818.38 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,754.40 Typical High $14,125.38 | Facility | None | $3,235.94 | $5,754.40 | $14,125.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,174.90 | Professional | None | $562.34 | $645.65 | $1,174.90 |
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 $316.23 Median $549.54 Typical High $1,584.89 | Professional | None | $316.23 | $549.54 | $1,584.89 |
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 $257.04 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $380.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $66.07 | $66.07 |
Where New Jersey sits
The same service costs 10.2 times more in Texas 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· 27th of 51
$1,122
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.