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 $13.18 Median $3,388.44 Typical High $10,000.00 | Facility | None | $13.18 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $24.55 Typical High $39.81 | Professional | None | $13.18 | $24.55 | $39.81 |
AmeriHealth Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $97.72 | Professional | None | $57.54 | $74.13 | $97.72 |
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 $8.71 Median $20.89 Typical High $48.98 | Professional | None | $8.71 | $20.89 | $48.98 |
Emblem Health Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $53.70 | Professional | None | $37.15 | $50.12 | $53.70 |
Horizon BCBS Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $275.42 | Facility | None | $131.83 | $199.53 | $275.42 |
Horizon BCBS Setting Professional Modifier None Typical Low $13.80 Median $34.67 Typical High $52.48 | Professional | None | $13.80 | $34.67 | $52.48 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,801.89 | Facility | None | $309.03 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $6.76 Median $17.78 Typical High $38.02 | Professional | None | $6.76 | $17.78 | $38.02 |
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 $6.61 Median $10.23 Typical High $14.45 | Professional | 52 · Reduced service | $6.61 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $4.17 Typical High $5.89 | Professional | 53 · Discontinued | $2.63 | $4.17 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $15.49 Typical High $21.88 | Professional | 54 · Surgery only | $10.00 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $3.09 Typical High $4.37 | Professional | 55 · Aftercare only | $2.00 | $3.09 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $2.04 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.32 | $2.04 | $2.95 |
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
$23.99
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.