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 $8,912.51 Typical High $13,803.84 | Facility | None | $4,466.84 | $8,912.51 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,000.00 | Professional | None | $575.44 | $933.25 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $27,542.29 Typical High $44,668.36 | Facility | None | $1,995.26 | $27,542.29 | $44,668.36 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $14,791.08 Typical High $83,176.38 | Facility | None | $7,762.47 | $14,791.08 | $83,176.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,584.89 | Professional | None | $794.33 | $912.01 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $9,332.54 Typical High $23,442.29 | Facility | None | $1,905.46 | $9,332.54 | $23,442.29 |
United Setting Professional Modifier None Typical Low $346.74 Median $776.25 Typical High $2,290.87 | Professional | None | $346.74 | $776.25 | $2,290.87 |
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 $281.84 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $281.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $112.20 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $426.58 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $85.11 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $56.23 | $93.33 | $93.33 |
Where New Jersey sits
The same service costs 50.1 times more in Arkansas 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
$1,660
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.