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 $33.11 Median $100.00 Typical High $10,471.29 | Facility | None | $33.11 | $100.00 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $66.07 Typical High $131.83 | Professional | None | $33.11 | $66.07 | $131.83 |
AmeriHealth Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $100.00 | Professional | None | $53.70 | $61.66 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $165.96 Typical High $354.81 | Facility | None | $87.10 | $165.96 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $70.79 Typical High $177.83 | Professional | None | $27.54 | $70.79 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $16.22 Median $70.79 Typical High $169.82 | Professional | None | $16.22 | $70.79 | $169.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $158.49 Median $288.40 Typical High $812.83 | Facility | None | $158.49 | $288.40 | $812.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $44.67 Median $102.33 Typical High $181.97 | Professional | None | $44.67 | $102.33 | $181.97 |
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 $20.42 Median $60.26 Typical High $128.82 | Professional | None | $20.42 | $60.26 | $128.82 |
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 $16.60 Median $28.84 Typical High $50.12 | Professional | 52 · Reduced service | $16.60 | $28.84 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $11.48 Typical High $19.95 | Professional | 53 · Discontinued | $6.61 | $11.48 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $43.65 Typical High $74.13 | Professional | 54 · Surgery only | $24.55 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $8.71 Typical High $15.14 | Professional | 55 · Aftercare only | $5.01 | $8.71 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $5.75 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.31 | $5.75 | $10.00 |
Where New Jersey sits
The same service costs 3.5 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
$72.44
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.