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 $87.10 Median $3,388.44 Typical High $10,471.29 | Facility | None | $87.10 | $3,388.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $162.18 Typical High $194.98 | Professional | None | $70.79 | $162.18 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $165.96 | Professional | None | $72.44 | $72.44 | $165.96 |
AmeriHealth Setting Facility Modifier None Typical Low $537.03 Median $6,760.83 Typical High $12,589.25 | Facility | None | $537.03 | $6,760.83 | $12,589.25 |
AmeriHealth Setting Professional Modifier None Typical Low $72.44 Median $173.78 Typical High $512.86 | Professional | None | $72.44 | $173.78 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $288.40 Typical High $467.74 | Facility | None | $66.07 | $288.40 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $257.04 | Professional | None | $81.28 | $162.18 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $288.40 | Professional | None | $208.93 | $288.40 | $288.40 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $87.10 Median $173.78 Typical High $338.84 | Professional | None | $87.10 | $173.78 | $338.84 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,412.54 Typical High $3,890.45 | Facility | None | $309.03 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $56.23 Median $134.90 Typical High $208.93 | Professional | None | $56.23 | $134.90 | $208.93 |
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 $35.48 Median $70.79 Typical High $93.33 | Professional | 52 · Reduced service | $35.48 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $28.18 Typical High $37.15 | Professional | 53 · Discontinued | $14.13 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $104.71 Typical High $138.04 | Professional | 54 · Surgery only | $52.48 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $21.38 Typical High $27.54 | Professional | 55 · Aftercare only | $10.72 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $14.13 Typical High $18.62 | Professional | 56 · Pre-op care only | $7.08 | $14.13 | $18.62 |
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· 38th of 51
$148
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.