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 $123.03 Median $4,570.88 Typical High $9,772.37 | Facility | None | $123.03 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $338.84 | Professional | None | $104.71 | $190.55 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,513.56 Typical High $2,238.72 | Facility | None | $707.95 | $1,513.56 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $549.54 | Professional | None | $79.43 | $199.53 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $446.68 | Professional | None | $288.40 | $446.68 | $446.68 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $7,244.36 | Facility | None | $1,288.25 | $2,344.23 | $7,244.36 |
Horizon BCBS Setting Professional Modifier None Typical Low $109.65 Median $316.23 Typical High $588.84 | Professional | None | $109.65 | $316.23 | $588.84 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $83.18 Median $208.93 Typical High $489.78 | Professional | None | $83.18 | $208.93 | $489.78 |
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 $51.29 Median $93.33 Typical High $117.49 | Professional | 52 · Reduced service | $51.29 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $38.02 Typical High $47.86 | Professional | 53 · Discontinued | $20.89 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $141.25 Typical High $177.83 | Professional | 54 · Surgery only | $77.62 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $28.18 Typical High $35.48 | Professional | 55 · Aftercare only | $15.49 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $19.05 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.47 | $19.05 | $23.99 |
Where New Jersey sits
The same service costs 3.9 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· 47th of 51
$234
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.