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 $288.40 Median $6,918.31 Typical High $12,882.50 | Facility | None | $288.40 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $288.40 | Professional | None | $181.97 | $245.47 | $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 $190.55 Median $302.00 Typical High $457.09 | Professional | None | $190.55 | $302.00 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $602.56 | Professional | None | $436.52 | $602.56 | $602.56 |
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 $199.53 Median $354.81 Typical High $630.96 | Professional | None | $199.53 | $354.81 | $630.96 |
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 $144.54 Median $263.03 Typical High $407.38 | Professional | None | $144.54 | $263.03 | $407.38 |
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 $89.13 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $89.13 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $36.31 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $177.83 Typical High $218.78 | Professional | 54 · Surgery only | $134.90 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $23.99 | $28.84 |
Where New Jersey sits
The same service costs 3.8 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· 35th of 51
$282
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.