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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $70.79 | Professional | None | $58.88 | $66.07 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $537.03 Typical High $933.25 | Facility | None | $251.19 | $537.03 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $134.90 | Professional | None | $45.71 | $74.13 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $83.18 | Professional | None | $60.26 | $79.43 | $83.18 |
Horizon BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,023.29 Typical High $2,754.23 | Facility | None | $562.34 | $1,023.29 | $2,754.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $147.91 | Professional | None | $72.44 | $85.11 | $147.91 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $128.82 | Professional | None | $39.81 | $52.48 | $128.82 |
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 $29.51 Median $29.51 Typical High $33.88 | Professional | 52 · Reduced service | $29.51 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $13.80 | Professional | 53 · Discontinued | $11.75 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $51.29 | Professional | 54 · Surgery only | $44.67 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $10.23 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.76 |
Where New Jersey sits
The same service costs 5.5 times more in Arkansas 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· 43rd of 51
$85.11
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.