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 $52.48 Median $3,235.94 Typical High $10,000.00 | Facility | None | $52.48 | $3,235.94 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $131.83 Typical High $194.98 | Professional | None | $47.86 | $131.83 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $87.10 Typical High $154.88 | Professional | None | $38.90 | $87.10 | $154.88 |
AmeriHealth Setting Facility Modifier None Typical Low $537.03 Median $4,168.69 Typical High $8,317.64 | Facility | None | $537.03 | $4,168.69 | $8,317.64 |
AmeriHealth Setting Professional Modifier None Typical Low $43.65 Median $112.20 Typical High $281.84 | Professional | None | $43.65 | $112.20 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $158.49 Typical High $263.03 | Professional | None | $48.98 | $158.49 | $263.03 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $263.03 | Professional | None | $186.21 | $257.04 | $263.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $53.70 Median $181.97 Typical High $331.13 | Professional | None | $53.70 | $181.97 | $331.13 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,148.15 | $3,311.31 | $5,888.44 |
United Setting Professional Modifier None Typical Low $40.74 Median $128.82 Typical High $269.15 | Professional | None | $40.74 | $128.82 | $269.15 |
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 $25.12 Median $54.95 Typical High $83.18 | Professional | 52 · Reduced service | $25.12 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $21.88 Typical High $33.11 | Professional | 53 · Discontinued | $10.23 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $83.18 Typical High $125.89 | Professional | 54 · Surgery only | $38.02 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $16.60 Typical High $25.12 | Professional | 55 · Aftercare only | $7.59 | $16.60 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $10.96 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.13 | $10.96 | $16.60 |
Where New Jersey sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 31st of 51
$135
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.