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 $33.11 Median $2,754.23 Typical High $9,772.37 | Facility | None | $33.11 | $2,754.23 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $58.88 Typical High $100.00 | Professional | None | $28.18 | $58.88 | $100.00 |
AmeriHealth Setting Facility Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $4,073.80 | Facility | None | $1,023.29 | $2,187.76 | $4,073.80 |
AmeriHealth Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $245.47 | Professional | None | $85.11 | $107.15 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $56.23 Typical High $123.03 | Professional | None | $23.44 | $56.23 | $123.03 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $147.91 | Professional | None | $104.71 | $138.04 | $147.91 |
Horizon BCBS Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $933.25 | Facility | None | $446.68 | $676.08 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $36.31 Median $91.20 Typical High $134.90 | Professional | None | $36.31 | $91.20 | $134.90 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $19.05 Median $48.98 Typical High $102.33 | Professional | None | $19.05 | $48.98 | $102.33 |
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 $14.13 Median $23.44 Typical High $35.48 | Professional | 52 · Reduced service | $14.13 | $23.44 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $9.33 Typical High $14.13 | Professional | 53 · Discontinued | $5.62 | $9.33 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $35.48 Typical High $53.70 | Professional | 54 · Surgery only | $21.38 | $35.48 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $7.08 Typical High $10.72 | Professional | 55 · Aftercare only | $4.27 | $7.08 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.68 Typical High $7.08 | Professional | 56 · Pre-op care only | $2.82 | $4.68 | $7.08 |
Where New Jersey sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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
$58.88
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.