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 $512.86 Median $549.54 Typical High $549.54 | Professional | None | $512.86 | $549.54 | $549.54 |
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 $446.68 Median $512.86 Typical High $1,258.93 | Professional | None | $446.68 | $512.86 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $691.83 | Professional | None | $478.63 | $676.08 | $691.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $1,412.54 | Professional | None | $436.52 | $512.86 | $1,412.54 |
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 $416.87 Median $549.54 Typical High $1,380.38 | Professional | None | $416.87 | $549.54 | $1,380.38 |
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 $257.04 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $54.95 |
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· 48th of 51
$550
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.