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 $67.61 Median $4,365.16 Typical High $10,471.29 | Facility | None | $67.61 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $114.82 | Professional | None | $63.10 | $83.18 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $112.20 Typical High $380.19 | Facility | None | $63.10 | $112.20 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $151.36 | Professional | None | $66.07 | $89.13 | $151.36 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $151.36 | Professional | None | $112.20 | $151.36 | $151.36 |
Horizon BCBS Setting Facility Modifier None Typical Low $85.11 Median $154.88 Typical High $1,148.15 | Facility | None | $85.11 | $154.88 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $158.49 | Professional | None | $63.10 | $97.72 | $158.49 |
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 $47.86 Median $72.44 Typical High $112.20 | Professional | None | $47.86 | $72.44 | $112.20 |
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 $31.62 Median $36.31 Typical High $42.66 | Professional | 52 · Reduced service | $31.62 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $14.79 Typical High $16.98 | Professional | 53 · Discontinued | $12.88 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $54.95 Typical High $64.57 | Professional | 54 · Surgery only | $47.86 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.96 Typical High $12.88 | Professional | 55 · Aftercare only | $9.55 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.41 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.31 | $7.41 | $8.51 |
Where New Jersey sits
The same service costs 3.8 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· 46th of 51
$79.43
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.