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 $40.74 Median $67.61 Typical High $660.69 | Facility | None | $40.74 | $67.61 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $67.61 Typical High $83.18 | Professional | None | $40.74 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $28.18 Typical High $33.88 | Professional | 52 · Reduced service | $20.42 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $11.22 Typical High $13.49 | Professional | 53 · Discontinued | $8.13 | $11.22 | $13.49 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
AmeriHealth Setting Facility Modifier None Typical Low $1,698.24 Median $3,090.30 Typical High $5,011.87 | Facility | None | $1,698.24 | $3,090.30 | $5,011.87 |
AmeriHealth Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $186.21 | Professional | None | $60.26 | $93.33 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $63.10 Typical High $104.71 | Professional | None | $40.74 | $63.10 | $104.71 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $131.83 | Professional | None | $95.50 | $131.83 | $131.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $616.60 | Facility | None | $295.12 | $489.78 | $616.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $131.83 | Professional | None | $41.69 | $74.13 | $131.83 |
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 $32.36 Median $56.23 Typical High $87.10 | Professional | None | $32.36 | $56.23 | $87.10 |
2 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 55 · Aftercare only Typical Low $6.17 Median $8.91 Typical High $10.23 | Professional | 55 · Aftercare only | $6.17 | $8.91 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.89 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.07 | $5.89 | $6.76 |
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· 40th of 51
$63.10
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.