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 $43.65 Median $2,754.23 Typical High $10,000.00 | Facility | None | $43.65 | $2,754.23 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $100.00 | Professional | None | $40.74 | $50.12 | $100.00 |
AmeriHealth Setting Facility Modifier None Typical Low $1,995.26 Median $8,317.64 Typical High $15,135.61 | Facility | None | $1,995.26 | $8,317.64 | $15,135.61 |
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 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $56.23 Typical High $131.83 | Professional | None | $38.02 | $56.23 | $131.83 |
Emblem Health Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $95.50 | Professional | None | $64.57 | $95.50 | $95.50 |
Horizon BCBS Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $169.82 | Professional | None | $46.77 | $67.61 | $169.82 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,412.54 Typical High $3,890.45 | Facility | None | $309.03 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $27.54 Median $44.67 Typical High $117.49 | Professional | None | $27.54 | $44.67 | $117.49 |
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 $20.42 Median $25.12 Typical High $26.30 | Professional | 52 · Reduced service | $20.42 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.00 Typical High $10.47 | Professional | 53 · Discontinued | $8.32 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $38.02 Typical High $39.81 | Professional | 54 · Surgery only | $30.90 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $6.17 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.01 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.07 | $5.01 | $5.25 |
Where New Jersey sits
The same service costs 4.8 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· 49th of 51
$58.88
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.