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 $3,630.78 Median $7,079.46 Typical High $11,748.98 | Facility | None | $3,630.78 | $7,079.46 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $3,235.94 Typical High $3,981.07 | Professional | None | $223.87 | $3,235.94 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,890.45 Typical High $6,606.93 | Facility | None | $1,995.26 | $3,890.45 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $2,398.83 Typical High $7,762.47 | Professional | None | $169.82 | $2,398.83 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $5,011.87 | Professional | None | $3,235.94 | $5,011.87 | $5,011.87 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $7,244.36 Typical High $26,302.68 | Facility | None | $4,073.80 | $7,244.36 | $26,302.68 |
Horizon BCBS Setting Professional Modifier None Typical Low $239.88 Median $3,981.07 Typical High $8,128.31 | Professional | None | $239.88 | $3,981.07 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,318.26 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $173.78 Median $1,949.84 Typical High $6,456.54 | Professional | None | $173.78 | $1,949.84 | $6,456.54 |
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 $112.20 Median $851.14 Typical High $1,995.26 | Professional | 52 · Reduced service | $112.20 | $851.14 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $338.84 Typical High $794.33 | Professional | 53 · Discontinued | $44.67 | $338.84 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $1,288.25 Typical High $2,951.21 | Professional | 54 · Surgery only | $165.96 | $1,288.25 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $257.04 Typical High $588.84 | Professional | 55 · Aftercare only | $33.88 | $257.04 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $169.82 Typical High $398.11 | Professional | 56 · Pre-op care only | $22.39 | $169.82 | $398.11 |
Where New Jersey sits
The same service costs 10.2 times more in Alaska than in Nebraska. 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
$2,754
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.