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 $2,754.23 Median $6,606.93 Typical High $11,481.54 | Facility | None | $2,754.23 | $6,606.93 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $263.03 | Professional | None | $104.71 | $169.82 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,511.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $229.09 Typical High $537.03 | Professional | None | $114.82 | $229.09 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | None | $316.23 | $478.63 | $478.63 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $4,365.16 Typical High $15,848.93 | Facility | None | $2,398.83 | $4,365.16 | $15,848.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $645.65 | Professional | None | $141.25 | $338.84 | $645.65 |
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 |
United Setting Professional Modifier None Typical Low $81.28 Median $190.55 Typical High $501.19 | Professional | None | $81.28 | $190.55 | $501.19 |
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 $51.29 Median $85.11 Typical High $131.83 | Professional | 52 · Reduced service | $51.29 | $85.11 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $34.67 Typical High $52.48 | Professional | 53 · Discontinued | $20.89 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $128.82 Typical High $194.98 | Professional | 54 · Surgery only | $77.62 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $25.70 Typical High $39.81 | Professional | 55 · Aftercare only | $15.49 | $25.70 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.98 Typical High $26.30 | Professional | 56 · Pre-op care only | $10.47 | $16.98 | $26.30 |
Where New Jersey sits
The same service costs 5.8 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· 43rd of 51
$251
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.