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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $158.49 | Professional | None | $75.86 | $117.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $165.96 Typical High $1,659.59 | Facility | None | $93.33 | $165.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $213.80 | Professional | None | $56.23 | $104.71 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $234.42 | Professional | None | $169.82 | $229.09 | $234.42 |
Horizon BCBS Setting Facility Modifier None Typical Low $138.04 Median $251.19 Typical High $2,884.03 | Facility | None | $138.04 | $251.19 | $2,884.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $89.13 Median $165.96 Typical High $263.03 | Professional | None | $89.13 | $165.96 | $263.03 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $42.66 Median $83.18 Typical High $186.21 | Professional | None | $42.66 | $83.18 | $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 $38.02 Median $57.54 Typical High $64.57 | Professional | 52 · Reduced service | $38.02 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $15.14 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | 54 · Surgery only | $56.23 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $17.38 Typical High $19.05 | Professional | 55 · Aftercare only | $11.22 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $11.48 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.59 | $11.48 | $12.88 |
Where New Jersey sits
The same service costs 3.2 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· 50th of 51
$120
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.