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 $338.84 Median $371.54 Typical High $389.05 | Professional | None | $338.84 | $371.54 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $812.83 Typical High $2,137.96 | Facility | None | $446.68 | $812.83 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $660.69 | Professional | None | $218.78 | $269.15 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Horizon BCBS Setting Facility Modifier None Typical Low $630.96 Median $1,122.02 Typical High $2,691.53 | Facility | None | $630.96 | $1,122.02 | $2,691.53 |
Horizon BCBS Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $1,000.00 | Professional | None | $302.00 | $354.81 | $1,000.00 |
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 $223.87 Median $302.00 Typical High $707.95 | Professional | None | $223.87 | $302.00 | $707.95 |
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 $165.96 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $165.96 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $77.62 | Professional | 53 · Discontinued | $66.07 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $38.90 |
Where New Jersey sits
The same service costs 4.1 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· 47th of 51
$389
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.