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 $53.70 Median $3,388.44 Typical High $10,000.00 | Facility | None | $53.70 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $131.83 Typical High $162.18 | Professional | None | $51.29 | $131.83 | $162.18 |
AmeriHealth Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $501.19 | Professional | None | $100.00 | $134.90 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $2,137.96 | Facility | None | $131.83 | $245.47 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $95.50 Typical High $234.42 | Professional | None | $34.67 | $95.50 | $234.42 |
Emblem Health Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $251.19 | Professional | None | $173.78 | $234.42 | $251.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $218.78 Median $380.19 Typical High $2,754.23 | Facility | None | $218.78 | $380.19 | $2,754.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $61.66 Median $162.18 Typical High $295.12 | Professional | None | $61.66 | $162.18 | $295.12 |
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 $25.70 Median $81.28 Typical High $177.83 | Professional | None | $25.70 | $81.28 | $177.83 |
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 $25.12 Median $36.31 Typical High $67.61 | Professional | 52 · Reduced service | $25.12 | $36.31 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $14.45 Typical High $26.92 | Professional | 53 · Discontinued | $10.23 | $14.45 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $54.95 Typical High $102.33 | Professional | 54 · Surgery only | $38.02 | $54.95 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.96 Typical High $20.42 | Professional | 55 · Aftercare only | $7.59 | $10.96 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $13.18 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.13 | $13.18 | $13.49 |
Where New Jersey sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 48th of 51
$117
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.