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 $426.58 Median $436.52 Typical High $524.81 | Professional | None | $426.58 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,309.57 Typical High $11,220.18 | Facility | None | $1,995.26 | $6,309.57 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $1,258.93 | Professional | None | $457.09 | $537.03 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $724.44 | Professional | None | $501.19 | $707.95 | $724.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $8,317.64 Typical High $39,810.72 | Facility | None | $4,570.88 | $8,317.64 | $39,810.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $1,318.26 | Professional | None | $457.09 | $537.03 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $1,023.29 | Professional | None | $331.13 | $436.52 | $1,023.29 |
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 $208.93 Median $208.93 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $85.11 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $52.48 |
Where New Jersey sits
The same service costs 3.9 times more in Alaska 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· 38th of 51
$631
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.