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 $1,348.96 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,348.96 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,025.60 Typical High $10,715.19 | Facility | None | $1,995.26 | $6,025.60 | $10,715.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $9,332.54 Typical High $27,542.29 | Facility | None | $5,128.61 | $9,332.54 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,380.38 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,786.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,778.28 | Professional | None | $912.01 | $1,148.15 | $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 $676.08 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $676.08 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $141.25 |
Where New Jersey sits
The same service costs 5.9 times more in Texas than in Kentucky. 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· 43rd of 51
$1,349
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.