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 $70.79 Median $3,388.44 Typical High $10,000.00 | Facility | None | $70.79 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $229.09 | Professional | None | $69.18 | $158.49 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $173.78 Typical High $316.23 | Professional | None | $66.07 | $173.78 | $316.23 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | None | $223.87 | $309.03 | $309.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $70.79 Median $213.80 Typical High $426.58 | Professional | None | $70.79 | $213.80 | $426.58 |
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 $53.70 Median $151.36 Typical High $331.13 | Professional | None | $53.70 | $151.36 | $331.13 |
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 $34.67 Median $64.57 Typical High $91.20 | Professional | 52 · Reduced service | $34.67 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $25.70 Typical High $36.31 | Professional | 53 · Discontinued | $13.80 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $95.50 Typical High $134.90 | Professional | 54 · Surgery only | $51.29 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $10.23 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $12.88 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.92 | $12.88 | $18.20 |
Where New Jersey sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 27th of 51
$166
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.