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 $63.10 Median $1,380.38 Typical High $9,772.37 | Facility | None | $63.10 | $1,380.38 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $128.82 | Professional | None | $63.10 | $95.50 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $151.36 Typical High $151.36 | Professional | None | $41.69 | $151.36 | $151.36 |
AmeriHealth Setting Facility Modifier None Typical Low $537.03 Median $1,621.81 Typical High $8,317.64 | Facility | None | $537.03 | $1,621.81 | $8,317.64 |
AmeriHealth Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $251.19 | Professional | None | $91.20 | $123.03 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $128.82 Typical High $467.74 | Facility | None | $67.61 | $128.82 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $158.49 | Professional | None | $58.88 | $95.50 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $169.82 | Professional | None | $123.03 | $169.82 | $169.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $100.00 Median $186.21 Typical High $1,258.93 | Facility | None | $100.00 | $186.21 | $1,258.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $177.83 | Professional | None | $57.54 | $107.15 | $177.83 |
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 $40.74 Median $79.43 Typical High $120.23 | Professional | None | $40.74 | $79.43 | $120.23 |
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 $41.69 Typical High $51.29 | Professional | 52 · Reduced service | $31.62 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.60 Typical High $20.42 | Professional | 53 · Discontinued | $12.59 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $63.10 Typical High $77.62 | Professional | 54 · Surgery only | $47.86 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $9.55 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.32 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.31 | $8.32 | $10.23 |
Where New Jersey sits
The same service costs 3.7 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· 45th of 51
$91.20
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.