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 $141.25 Median $4,570.88 Typical High $9,772.37 | Facility | None | $141.25 | $4,570.88 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $323.59 | Professional | None | $117.49 | $181.97 | $323.59 |
AmeriHealth Setting Facility Modifier None Typical Low $3,801.89 Median $6,606.93 Typical High $9,332.54 | Facility | None | $3,801.89 | $6,606.93 | $9,332.54 |
AmeriHealth Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $426.58 | Professional | None | $218.78 | $295.12 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $269.15 Typical High $1,659.59 | Facility | None | $151.36 | $269.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $398.11 | Professional | None | $79.43 | $154.88 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | None | $208.93 | $316.23 | $316.23 |
Horizon BCBS Setting Facility Modifier None Typical Low $223.87 Median $426.58 Typical High $1,479.11 | Facility | None | $223.87 | $426.58 | $1,479.11 |
Horizon BCBS Setting Professional Modifier None Typical Low $112.20 Median $223.87 Typical High $524.81 | Professional | None | $112.20 | $223.87 | $524.81 |
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 $83.18 Median $162.18 Typical High $363.08 | Professional | None | $83.18 | $162.18 | $363.08 |
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 $58.88 Median $89.13 Typical High $107.15 | Professional | 52 · Reduced service | $58.88 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $23.44 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $131.83 Typical High $158.49 | Professional | 54 · Surgery only | $89.13 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $17.78 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.75 | $17.78 | $21.38 |
Where New Jersey sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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· 37th of 51
$209
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.