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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $109.65 Typical High $141.25 | Professional | None | $53.70 | $109.65 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,995.26 | Facility | None | $616.60 | $1,202.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $131.83 Typical High $338.84 | Professional | None | $54.95 | $131.83 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $269.15 | Professional | None | $181.97 | $269.15 | $269.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $6,760.83 | Facility | None | $1,174.90 | $2,137.96 | $6,760.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $66.07 Median $177.83 Typical High $338.84 | Professional | None | $66.07 | $177.83 | $338.84 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $39.81 Median $102.33 Typical High $281.84 | Professional | None | $39.81 | $102.33 | $281.84 |
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 $26.92 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $26.92 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $10.72 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $83.18 Typical High $100.00 | Professional | 54 · Surgery only | $39.81 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $7.94 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.37 | $10.96 | $13.49 |
Where New Jersey sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 46th of 51
$132
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.