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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | None | $281.84 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $16,982.44 Typical High $28,183.83 | Facility | None | $1,995.26 | $16,982.44 | $28,183.83 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $16,218.10 Typical High $47,863.01 | Facility | None | $8,912.51 | $16,218.10 | $47,863.01 |
Horizon BCBS Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $436.52 | Professional | None | $251.19 | $288.40 | $436.52 |
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 $154.88 Median $199.53 Typical High $436.52 | Professional | None | $154.88 | $199.53 | $436.52 |
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 $141.25 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $30.20 |
Where New Jersey sits
The same service costs 9.5 times more in Arkansas 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· 37th of 51
$288
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.