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 $234.42 Median $6,918.31 Typical High $12,882.50 | Facility | None | $234.42 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $371.54 | Professional | None | $162.18 | $218.78 | $371.54 |
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 $173.78 Median $275.42 Typical High $407.38 | Professional | None | $173.78 | $275.42 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $562.34 | Professional | None | $407.38 | $562.34 | $562.34 |
Horizon BCBS Setting Facility Modifier None Typical Low $218.78 Median $416.87 Typical High $1,047.13 | Facility | None | $218.78 | $416.87 | $1,047.13 |
Horizon BCBS Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $562.34 | Professional | None | $181.97 | $323.59 | $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 $128.82 Median $234.42 Typical High $380.19 | Professional | None | $128.82 | $234.42 | $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 $79.43 Median $109.65 Typical High $181.97 | Professional | 52 · Reduced service | $79.43 | $109.65 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $43.65 Typical High $74.13 | Professional | 53 · Discontinued | $32.36 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $162.18 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $162.18 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $32.36 Typical High $54.95 | Professional | 55 · Aftercare only | $23.99 | $32.36 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $37.15 |
Where New Jersey sits
The same service costs 4.0 times more in Alaska than in Maryland. 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
$234
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.