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 $141.25 Typical High $10,471.29 | Facility | None | $56.23 | $141.25 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $162.18 | Professional | None | $56.23 | $95.50 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
AmeriHealth Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $134.90 | Professional | None | $52.48 | $57.54 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $199.53 Typical High $363.08 | Facility | None | $109.65 | $199.53 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $102.33 Typical High $245.47 | Professional | None | $44.67 | $102.33 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $24.55 Median $102.33 Typical High $229.09 | Professional | None | $24.55 | $102.33 | $229.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $1,659.59 | Facility | None | $199.53 | $354.81 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $72.44 Median $147.91 Typical High $239.88 | Professional | None | $72.44 | $147.91 | $239.88 |
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 $33.88 Median $81.28 Typical High $186.21 | Professional | None | $33.88 | $81.28 | $186.21 |
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 $27.54 Median $46.77 Typical High $70.79 | Professional | 52 · Reduced service | $27.54 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $19.05 Typical High $28.18 | Professional | 53 · Discontinued | $11.22 | $19.05 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $70.79 Typical High $104.71 | Professional | 54 · Surgery only | $41.69 | $70.79 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $14.13 Typical High $21.38 | Professional | 55 · Aftercare only | $8.32 | $14.13 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $9.33 Typical High $14.13 | Professional | 56 · Pre-op care only | $5.62 | $9.33 | $14.13 |
Where New Jersey sits
The same service costs 3.2 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
$102
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.