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 $109.65 Median $6,918.31 Typical High $12,882.50 | Facility | None | $109.65 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $120.23 | Professional | None | $79.43 | $109.65 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $181.97 Typical High $354.81 | Facility | None | $95.50 | $181.97 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $199.53 | Professional | None | $63.10 | $112.20 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $257.04 | Professional | None | $181.97 | $245.47 | $257.04 |
Horizon BCBS Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $2,754.23 | Facility | None | $134.90 | $245.47 | $2,754.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $263.03 | Professional | None | $100.00 | $165.96 | $263.03 |
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 $47.86 Median $89.13 Typical High $194.98 | Professional | None | $47.86 | $89.13 | $194.98 |
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 $39.81 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $21.38 Typical High $23.99 | Professional | 53 · Discontinued | $15.85 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $81.28 Typical High $89.13 | Professional | 54 · Surgery only | $58.88 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $11.75 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $10.72 | $12.02 |
Where New Jersey sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 48th of 51
$117
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.