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 $87.10 Median $4,466.84 Typical High $9,772.37 | Facility | None | $87.10 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $181.97 | Professional | None | $83.18 | $128.82 | $181.97 |
AmeriHealth Setting Facility Modifier None Typical Low $263.03 Median $549.54 Typical High $2,754.23 | Facility | None | $263.03 | $549.54 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $1,659.59 | Facility | None | $112.20 | $199.53 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $114.82 Typical High $223.87 | Professional | None | $56.23 | $114.82 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $263.03 | Professional | None | $181.97 | $245.47 | $263.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $165.96 Median $302.00 Typical High $3,019.95 | Facility | None | $165.96 | $302.00 | $3,019.95 |
Horizon BCBS Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $302.00 | Professional | None | $91.20 | $181.97 | $302.00 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $44.67 Median $91.20 Typical High $199.53 | Professional | None | $44.67 | $91.20 | $199.53 |
6 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 $41.69 Median $58.88 Typical High $67.61 | Professional | 52 · Reduced service | $41.69 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.44 Typical High $26.92 | Professional | 53 · Discontinued | $16.60 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $89.13 Typical High $102.33 | Professional | 54 · Surgery only | $61.66 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.78 Typical High $20.42 | Professional | 55 · Aftercare only | $12.30 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.75 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.32 | $11.75 | $13.49 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 51 · Multiple procedures | $45.71 | $45.71 | $45.71 |
Where New Jersey sits
The same service costs 3.2 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
$129
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.