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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,479.11 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,023.29 | $2,137.96 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,762.47 Typical High $19,952.62 | Facility | None | $4,168.69 | $7,762.47 | $19,952.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $3,235.94 | Professional | None | $1,258.93 | $1,445.44 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $6,606.93 | Facility | None | $1,122.02 | $2,818.38 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $3,235.94 | Professional | None | $1,023.29 | $1,348.96 | $3,235.94 |
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 $588.84 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $891.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $147.91 | $147.91 |
Where New Jersey sits
The same service costs 109.6 times more in Alaska 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
$1,514
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.