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 $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,778.28 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $9,772.37 Typical High $17,378.01 | Facility | None | $1,995.26 | $9,772.37 | $17,378.01 |
Emblem Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Horizon BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $12,302.69 Typical High $43,651.58 | Facility | None | $6,606.93 | $12,302.69 | $43,651.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Professional | None | $1,513.56 | $1,737.80 | $3,890.45 |
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 $1,288.25 Median $1,659.59 Typical High $7,413.10 | Professional | None | $1,288.25 | $1,659.59 | $7,413.10 |
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 $707.95 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,071.52 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $213.80 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $177.83 | $177.83 |
Where New Jersey sits
The same service costs 4.9 times more in Alaska than in Indiana. 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· 46th of 51
$1,950
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.