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 $74.13 Median $162.18 Typical High $10,471.29 | Facility | None | $74.13 | $162.18 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $190.55 | Professional | None | $74.13 | $120.23 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $218.78 Typical High $380.19 | Facility | None | $123.03 | $218.78 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $288.40 | Professional | None | $58.88 | $120.23 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $288.40 | Professional | None | $199.53 | $269.15 | $288.40 |
Horizon BCBS Setting Facility Modifier None Typical Low $218.78 Median $389.05 Typical High $1,513.56 | Facility | None | $218.78 | $389.05 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $275.42 | Professional | None | $93.33 | $186.21 | $275.42 |
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 $42.66 Median $95.50 Typical High $218.78 | Professional | None | $42.66 | $95.50 | $218.78 |
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 $37.15 Median $58.88 Typical High $81.28 | Professional | 52 · Reduced service | $37.15 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $23.99 Typical High $32.36 | Professional | 53 · Discontinued | $14.79 | $23.99 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $89.13 Typical High $123.03 | Professional | 54 · Surgery only | $56.23 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $17.78 Typical High $24.55 | Professional | 55 · Aftercare only | $11.22 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.02 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.41 | $12.02 | $16.22 |
Where New Jersey sits
The same service costs 3.3 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· 49th of 51
$126
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.