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 $147.91 Median $4,570.88 Typical High $9,772.37 | Facility | None | $147.91 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $275.42 | Professional | None | $125.89 | $204.17 | $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 $562.34 | Professional | None | $91.20 | $204.17 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $457.09 | Professional | None | $302.00 | $457.09 | $457.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $1,584.89 | Facility | None | $346.74 | $602.56 | $1,584.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $123.03 Median $323.59 Typical High $616.60 | Professional | None | $123.03 | $323.59 | $616.60 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,890.45 | Facility | None | $309.03 | $1,380.38 | $3,890.45 |
United Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $501.19 | Professional | None | $95.50 | $218.78 | $501.19 |
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 $63.10 Median $102.33 Typical High $128.82 | Professional | 52 · Reduced service | $63.10 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $40.74 Typical High $51.29 | Professional | 53 · Discontinued | $25.12 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $93.33 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $19.05 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $20.42 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.59 | $20.42 | $25.70 |
Where New Jersey sits
The same service costs 3.1 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· 48th of 51
$240
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.