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 $251.19 Median $251.19 Typical High $275.42 | Professional | None | $251.19 | $251.19 | $275.42 |
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 $223.87 Median $257.04 Typical High $616.60 | Professional | None | $223.87 | $257.04 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $346.74 | Professional | None | $239.88 | $338.84 | $346.74 |
Horizon BCBS Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $676.08 | Professional | None | $218.78 | $257.04 | $676.08 |
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 $208.93 Median $263.03 Typical High $691.83 | Professional | None | $208.93 | $263.03 | $691.83 |
4 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 $125.89 Median $125.89 Typical High $134.90 | Professional | 52 · Reduced service | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | 53 · Discontinued | $51.29 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $26.92 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $26.92 |
Where New Jersey sits
The same service costs 4.1 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· 45th of 51
$295
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.