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 $295.12 Median $302.00 Typical High $338.84 | Professional | None | $295.12 | $302.00 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,071.52 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $741.31 | Professional | None | $269.15 | $288.40 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $416.87 | Professional | None | $288.40 | $407.38 | $416.87 |
Horizon BCBS Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $812.83 | Professional | None | $269.15 | $316.23 | $812.83 |
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 $257.04 Median $316.23 Typical High $851.14 | Professional | None | $257.04 | $316.23 | $851.14 |
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 $151.36 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $151.36 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $60.26 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $32.36 |
Where New Jersey sits
The same service costs 3.9 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· 49th of 51
$339
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.