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 $22.91 Median $85.11 Typical High $10,471.29 | Facility | None | $22.91 | $85.11 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $52.48 Typical High $114.82 | Professional | None | $22.91 | $52.48 | $114.82 |
AmeriHealth Setting Professional Modifier None Typical Low $41.69 Median $97.72 Typical High $588.84 | Professional | None | $41.69 | $97.72 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $63.10 Typical High $151.36 | Professional | None | $20.89 | $63.10 | $151.36 |
Emblem Health Setting Professional Modifier None Typical Low $16.22 Median $51.29 Typical High $147.91 | Professional | None | $16.22 | $51.29 | $147.91 |
Horizon BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,344.23 | Facility | None | $912.01 | $1,513.56 | $2,344.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $158.49 | Professional | None | $33.11 | $85.11 | $158.49 |
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 $15.49 Median $51.29 Typical High $109.65 | Professional | None | $15.49 | $51.29 | $109.65 |
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 $11.48 Median $21.38 Typical High $42.66 | Professional | 52 · Reduced service | $11.48 | $21.38 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $8.51 Typical High $16.98 | Professional | 53 · Discontinued | $4.57 | $8.51 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $32.36 Typical High $64.57 | Professional | 54 · Surgery only | $16.98 | $32.36 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $6.46 Typical High $12.88 | Professional | 55 · Aftercare only | $3.39 | $6.46 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $5.25 Typical High $8.51 | Professional | 56 · Pre-op care only | $2.29 | $5.25 | $8.51 |
Where New Jersey sits
The same service costs 3.3 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· 50th of 51
$56.23
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.