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 $660.69 Median $6,309.57 Typical High $10,471.29 | Facility | None | $660.69 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | None | $660.69 | $660.69 | $891.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | 52 · Reduced service | $331.13 | $331.13 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | 54 · Surgery only | $489.78 | $489.78 | $660.69 |
AmeriHealth Setting Facility Modifier None Typical Low $4,265.80 Median $7,943.28 Typical High $12,882.50 | Facility | None | $4,265.80 | $7,943.28 | $12,882.50 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $4,265.80 | Facility | None | $1,174.90 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $588.84 Typical High $1,905.46 | Professional | None | $125.89 | $588.84 | $1,905.46 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $5,623.41 Typical High $13,182.57 | Facility | None | $3,019.95 | $5,623.41 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
3 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 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $177.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $89.13 |
Where New Jersey sits
The same service costs 74.1 times more in Oklahoma than in Montana. 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· 15th of 51
$1,820
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.