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 $61.66 Median $3,235.94 Typical High $10,000.00 | Facility | None | $61.66 | $3,235.94 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $162.18 | Professional | None | $51.29 | $104.71 | $162.18 |
AmeriHealth Setting Facility Modifier None Typical Low $831.76 Median $2,754.23 Typical High $10,471.29 | Facility | None | $831.76 | $2,754.23 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $128.82 Typical High $354.81 | Facility | None | $66.07 | $128.82 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $245.47 | Professional | None | $43.65 | $85.11 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $165.96 | Professional | None | $107.15 | $165.96 | $165.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $114.82 Median $204.17 Typical High $1,659.59 | Facility | None | $114.82 | $204.17 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $52.48 Median $114.82 Typical High $302.00 | Professional | None | $52.48 | $114.82 | $302.00 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $30.20 Median $67.61 Typical High $190.55 | Professional | None | $30.20 | $67.61 | $190.55 |
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 $26.92 Median $42.66 Typical High $66.07 | Professional | 52 · Reduced service | $26.92 | $42.66 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $17.38 Typical High $26.30 | Professional | 53 · Discontinued | $10.72 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $64.57 Typical High $100.00 | Professional | 54 · Surgery only | $39.81 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.88 Typical High $19.95 | Professional | 55 · Aftercare only | $7.94 | $12.88 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.71 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.37 | $8.71 | $13.18 |
Where New Jersey sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 34th of 51
$107
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.