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 $13,803.84 | Facility | None | $4,365.16 | $6,918.31 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $758.58 | Professional | None | $457.09 | $478.63 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,023.29 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $1,148.15 | Professional | None | $398.11 | $446.68 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $616.60 | Professional | None | $436.52 | $602.56 | $616.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $1,230.27 | Professional | None | $398.11 | $467.74 | $1,230.27 |
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 $380.19 Median $489.78 Typical High $1,258.93 | Professional | None | $380.19 | $489.78 | $1,258.93 |
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 $229.09 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $47.86 |
Where New Jersey sits
The same service costs 4.1 times more in Wisconsin than in Kentucky. 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· 43rd of 51
$513
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.