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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | None | $776.25 | $776.25 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,023.29 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,949.84 | Professional | None | $707.95 | $812.83 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,096.48 | Professional | None | $758.58 | $1,047.13 | $1,096.48 |
Horizon BCBS Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $2,137.96 | Professional | None | $691.83 | $831.76 | $2,137.96 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $2,187.76 | Professional | None | $660.69 | $851.14 | $2,187.76 |
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 $389.05 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $588.84 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $83.18 |
Where New Jersey sits
The same service costs 3.8 times more in Wisconsin 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· 47th of 51
$832
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.