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 $4,570.88 Typical High $10,471.29 | Facility | None | $87.10 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $144.54 | Professional | None | $87.10 | $95.50 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | None | $45.71 | $47.86 | $50.12 |
AmeriHealth Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | None | $52.48 | $52.48 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $218.78 | Professional | None | $60.26 | $100.00 | $218.78 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $162.18 | Professional | None | $109.65 | $144.54 | $162.18 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,513.56 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $199.53 | Professional | None | $102.33 | $120.23 | $199.53 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,148.15 | $3,311.31 | $5,888.44 |
United Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $199.53 | Professional | None | $52.48 | $81.28 | $199.53 |
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 $43.65 Median $43.65 Typical High $48.98 | Professional | 52 · Reduced service | $43.65 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $17.38 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 54 · Surgery only | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $14.79 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.77 |
Where New Jersey sits
The same service costs 3.5 times more in Wisconsin than in New York. 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
$102
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.