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 $190.55 Median $223.87 Typical High $234.42 | Professional | None | $190.55 | $223.87 | $234.42 |
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 $125.89 Median $151.36 Typical High $380.19 | Professional | None | $125.89 | $151.36 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Horizon BCBS Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $549.54 | Professional | None | $169.82 | $199.53 | $549.54 |
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 $128.82 Median $173.78 Typical High $398.11 | Professional | None | $128.82 | $173.78 | $398.11 |
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 $93.33 Median $112.20 Typical High $117.49 | Professional | 52 · Reduced service | $93.33 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $45.71 Typical High $47.86 | Professional | 53 · Discontinued | $37.15 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $169.82 Typical High $177.83 | Professional | 54 · Surgery only | $141.25 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $35.48 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.39 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.62 | $22.39 | $23.44 |
Where New Jersey sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 41st of 51
$229
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.