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 $47.86 Median $123.03 Typical High $10,471.29 | Facility | None | $47.86 | $123.03 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $158.49 | Professional | None | $47.86 | $85.11 | $158.49 |
AmeriHealth Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $173.78 | Professional | None | $67.61 | $74.13 | $173.78 |
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 $36.31 Median $91.20 Typical High $218.78 | Professional | None | $36.31 | $91.20 | $218.78 |
Emblem Health Setting Professional Modifier None Typical Low $24.55 Median $72.44 Typical High $181.97 | Professional | None | $24.55 | $72.44 | $181.97 |
Horizon BCBS Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $933.25 | Facility | None | $446.68 | $741.31 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $58.88 Median $131.83 Typical High $213.80 | Professional | None | $58.88 | $131.83 | $213.80 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $26.92 Median $70.79 Typical High $158.49 | Professional | None | $26.92 | $70.79 | $158.49 |
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 $23.99 Median $38.02 Typical High $61.66 | Professional | 52 · Reduced service | $23.99 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.14 Typical High $24.55 | Professional | 53 · Discontinued | $9.55 | $15.14 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $57.54 Typical High $93.33 | Professional | 54 · Surgery only | $36.31 | $57.54 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $11.48 Typical High $18.62 | Professional | 55 · Aftercare only | $7.24 | $11.48 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.59 Typical High $12.30 | Professional | 56 · Pre-op care only | $4.79 | $7.59 | $12.30 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 51st of 51
$85.11
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.