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 $2.14 Median $3,548.13 Typical High $10,232.93 | Facility | None | $2.14 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $4.90 Typical High $8.91 | Professional | None | $2.14 | $4.90 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $5.50 Median $6.92 Typical High $6.92 | Professional | None | $5.50 | $6.92 | $6.92 |
AmeriHealth Setting Facility Modifier None Typical Low $11,220.18 Median $24,547.09 Typical High $40,738.03 | Facility | None | $11,220.18 | $24,547.09 | $40,738.03 |
AmeriHealth Setting Professional Modifier None Typical Low $6.17 Median $7.76 Typical High $19.95 | Professional | None | $6.17 | $7.76 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $2,137.96 Typical High $3,019.95 | Facility | None | $251.19 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $4.07 Typical High $10.23 | Professional | None | $1.23 | $4.07 | $10.23 |
Emblem Health Setting Professional Modifier None Typical Low $7.24 Median $9.55 Typical High $10.47 | Professional | None | $7.24 | $9.55 | $10.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $2.00 Median $7.08 Typical High $13.80 | Professional | None | $2.00 | $7.08 | $13.80 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,412.54 Typical High $3,890.45 | Facility | None | $309.03 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $0.91 Median $3.39 Typical High $7.24 | Professional | None | $0.91 | $3.39 | $7.24 |
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 $1.07 Median $2.45 Typical High $4.47 | Professional | 52 · Reduced service | $1.07 | $2.45 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.98 Typical High $1.78 | Professional | 53 · Discontinued | $0.43 | $0.98 | $1.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.62 Median $3.16 Typical High $6.76 | Professional | 54 · Surgery only | $1.62 | $3.16 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.72 Typical High $1.35 | Professional | 55 · Aftercare only | $0.32 | $0.72 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.42 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.22 | $0.42 | $0.89 |
Where New Jersey sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$5.13
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.