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 $46.77 Median $812.83 Typical High $8,912.51 | Facility | None | $46.77 | $812.83 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $95.50 | Professional | None | $46.77 | $61.66 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $117.49 | Professional | None | $77.62 | $77.62 | $117.49 |
AmeriHealth Setting Facility Modifier None Typical Low $58.88 Median $3,715.35 Typical High $18,620.87 | Facility | None | $58.88 | $3,715.35 | $18,620.87 |
AmeriHealth Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $165.96 | Professional | None | $39.81 | $74.13 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $83.18 Typical High $1,659.59 | Facility | None | $46.77 | $83.18 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $109.65 | Professional | None | $44.67 | $66.07 | $109.65 |
Emblem Health Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $117.49 | Professional | None | $81.28 | $112.20 | $117.49 |
Horizon BCBS Setting Facility Modifier None Typical Low $63.10 Median $112.20 Typical High $1,258.93 | Facility | None | $63.10 | $112.20 | $1,258.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $134.90 | Professional | None | $43.65 | $70.79 | $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 $32.36 Median $52.48 Typical High $81.28 | Professional | None | $32.36 | $52.48 | $81.28 |
6 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 $23.44 Median $29.51 Typical High $39.81 | Professional | 52 · Reduced service | $23.44 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.75 Typical High $15.85 | Professional | 53 · Discontinued | $9.33 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $43.65 Typical High $58.88 | Professional | 54 · Surgery only | $35.48 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.91 Typical High $11.75 | Professional | 55 · Aftercare only | $7.08 | $8.91 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.89 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.68 | $5.89 | $7.94 |
AmeriHealth Setting Professional Modifier 58 · Staged procedure Typical Low $57.54 Median $70.79 Typical High $177.83 | Professional | 58 · Staged procedure | $57.54 | $70.79 | $177.83 |
Where New Jersey sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 47th of 51
$61.66
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.