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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $245.47 Typical High $281.84 | Professional | None | $77.62 | $245.47 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $588.84 Typical High $2,137.96 | Facility | None | $316.23 | $588.84 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $229.09 Typical High $602.56 | Professional | None | $72.44 | $229.09 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $575.44 | Professional | None | $371.54 | $575.44 | $575.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $2,691.53 | Facility | None | $407.38 | $758.58 | $2,691.53 |
Horizon BCBS Setting Professional Modifier None Typical Low $89.13 Median $338.84 Typical High $645.65 | Professional | None | $89.13 | $338.84 | $645.65 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $51.29 Median $199.53 Typical High $537.03 | Professional | None | $51.29 | $199.53 | $537.03 |
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 $38.90 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $38.90 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $15.49 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $58.88 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $11.75 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.76 | $23.99 | $25.70 |
Where New Jersey sits
The same service costs 4.3 times more in Oklahoma than in Nebraska. 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· 45th of 51
$251
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.