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 $56.23 Median $138.04 Typical High $10,471.29 | Facility | None | $56.23 | $138.04 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $173.78 | Professional | None | $56.23 | $100.00 | $173.78 |
AmeriHealth Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $117.49 | Professional | None | $60.26 | $79.43 | $117.49 |
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 $42.66 Median $100.00 Typical High $239.88 | Professional | None | $42.66 | $100.00 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $239.88 | Professional | None | $169.82 | $223.87 | $239.88 |
Horizon BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $1,905.46 | Facility | None | $912.01 | $1,380.38 | $1,905.46 |
Horizon BCBS Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $234.42 | Professional | None | $69.18 | $158.49 | $234.42 |
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 $32.36 Median $79.43 Typical High $181.97 | Professional | None | $32.36 | $79.43 | $181.97 |
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 $28.18 Median $44.67 Typical High $69.18 | Professional | 52 · Reduced service | $28.18 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $17.78 Typical High $27.54 | Professional | 53 · Discontinued | $11.22 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $67.61 Typical High $102.33 | Professional | 54 · Surgery only | $42.66 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $13.49 Typical High $20.42 | Professional | 55 · Aftercare only | $8.51 | $13.49 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.91 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.62 | $8.91 | $13.80 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$100
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.