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 $239.88 Median $6,918.31 Typical High $12,882.50 | Facility | None | $239.88 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $288.40 | Professional | None | $162.18 | $229.09 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $257.04 Typical High $389.05 | Facility | None | $162.18 | $257.04 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $457.09 | Professional | None | $181.97 | $281.84 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $549.54 | Professional | None | $407.38 | $549.54 | $549.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $229.09 Median $407.38 Typical High $1,047.13 | Facility | None | $229.09 | $407.38 | $1,047.13 |
Horizon BCBS Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $562.34 | Professional | None | $190.55 | $338.84 | $562.34 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,890.45 | Facility | None | $316.23 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $380.19 | Professional | None | $131.83 | $239.88 | $380.19 |
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 $81.28 Median $109.65 Typical High $144.54 | Professional | 52 · Reduced service | $81.28 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $44.67 Typical High $57.54 | Professional | 53 · Discontinued | $33.11 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $123.03 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.11 Typical High $43.65 | Professional | 55 · Aftercare only | $24.55 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $28.84 |
Where New Jersey sits
The same service costs 4.0 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· 42nd of 51
$240
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.