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 $70.79 Median $6,918.31 Typical High $12,882.50 | Facility | None | $70.79 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $83.18 | Professional | None | $48.98 | $70.79 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $354.81 | Facility | None | $66.07 | $123.03 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $125.89 | Professional | None | $50.12 | $74.13 | $125.89 |
Emblem Health Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $134.90 | Professional | None | $97.72 | $134.90 | $134.90 |
Horizon BCBS Setting Facility Modifier None Typical Low $100.00 Median $177.83 Typical High $660.69 | Facility | None | $100.00 | $177.83 | $660.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $154.88 | Professional | None | $54.95 | $91.20 | $154.88 |
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 $36.31 Median $64.57 Typical High $95.50 | Professional | None | $36.31 | $64.57 | $95.50 |
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 $24.55 Median $32.36 Typical High $40.74 | Professional | 52 · Reduced service | $24.55 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.88 Typical High $16.60 | Professional | 53 · Discontinued | $9.77 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $48.98 Typical High $61.66 | Professional | 54 · Surgery only | $37.15 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.77 Typical High $12.30 | Professional | 55 · Aftercare only | $7.41 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.46 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.90 | $6.46 | $8.32 |
Where New Jersey sits
The same service costs 3.6 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· 43rd of 51
$69.18
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.