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 $4,365.16 Median $6,606.93 Typical High $11,481.54 | Facility | None | $4,365.16 | $6,606.93 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | None | $204.17 | $204.17 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,090.30 | $5,248.07 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $575.44 | Professional | None | $134.90 | $251.19 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | None | $186.21 | $281.84 | $281.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $5,128.61 Typical High $28,840.32 | Facility | None | $2,884.03 | $5,128.61 | $28,840.32 |
Horizon BCBS Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $549.54 | Professional | None | $190.55 | $229.09 | $549.54 |
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 $131.83 Median $190.55 Typical High $446.68 | Professional | None | $131.83 | $190.55 | $446.68 |
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 $102.33 Median $102.33 Typical High $112.20 | Professional | 52 · Reduced service | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $45.71 | Professional | 53 · Discontinued | $40.74 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | 54 · Surgery only | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $22.39 |
Where New Jersey sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 41st of 51
$275
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.