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 $6,918.31 Typical High $12,882.50 | Facility | None | $87.10 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $83.18 Typical High $102.33 | Professional | None | $61.66 | $83.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $158.49 Typical High $354.81 | Facility | None | $83.18 | $158.49 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $165.96 | Professional | None | $70.79 | $95.50 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | None | $134.90 | $186.21 | $186.21 |
Horizon BCBS Setting Facility Modifier None Typical Low $112.20 Median $213.80 Typical High $1,047.13 | Facility | None | $112.20 | $213.80 | $1,047.13 |
Horizon BCBS Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $194.98 | Professional | None | $74.13 | $114.82 | $194.98 |
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 $52.48 Median $85.11 Typical High $131.83 | Professional | None | $52.48 | $85.11 | $131.83 |
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 $30.90 Median $40.74 Typical High $51.29 | Professional | 52 · Reduced service | $30.90 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.22 Typical High $20.42 | Professional | 53 · Discontinued | $12.59 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $61.66 Typical High $77.62 | Professional | 54 · Surgery only | $46.77 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.30 Typical High $15.49 | Professional | 55 · Aftercare only | $9.33 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.13 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.17 | $8.13 | $10.23 |
Where New Jersey sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 43rd of 51
$87.10
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.