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 $2,754.23 Median $5,754.40 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,754.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $275.42 | Professional | None | $114.82 | $218.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $2,187.76 | Facility | None | $257.04 | $457.09 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $537.03 | Professional | None | $91.20 | $204.17 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $446.68 | Professional | None | $295.12 | $446.68 | $446.68 |
Horizon BCBS Setting Facility Modifier None Typical Low $346.74 Median $645.65 Typical High $1,584.89 | Facility | None | $346.74 | $645.65 | $1,584.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $125.89 Median $309.03 Typical High $660.69 | Professional | None | $125.89 | $309.03 | $660.69 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $93.33 Median $213.80 Typical High $478.63 | Professional | None | $93.33 | $213.80 | $478.63 |
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 $57.54 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $57.54 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $22.91 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $87.10 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $17.38 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.48 | $21.88 | $27.54 |
Where New Jersey sits
The same service costs 3.2 times more in Wisconsin 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
$257
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.