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 $389.05 Median $5,495.41 Typical High $10,471.29 | Facility | None | $389.05 | $5,495.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | None | $389.05 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,801.89 Typical High $6,456.54 | Facility | None | $1,995.26 | $3,801.89 | $6,456.54 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $4,168.69 Typical High $12,302.69 | Facility | None | $2,344.23 | $4,168.69 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $602.56 | Professional | None | $354.81 | $407.38 | $602.56 |
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 $288.40 Median $338.84 Typical High $524.81 | Professional | None | $288.40 | $338.84 | $524.81 |
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 $194.98 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $79.43 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $295.12 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $41.69 |
Where New Jersey sits
The same service costs 28.2 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· 36th of 51
$398
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.