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 $812.83 Median $831.76 Typical High $912.01 | Professional | None | $812.83 | $831.76 | $912.01 |
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 $741.31 Median $851.14 Typical High $2,089.30 | Professional | None | $741.31 | $851.14 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,148.15 | Professional | None | $794.33 | $1,122.02 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $2,238.72 | Professional | None | $724.44 | $870.96 | $2,238.72 |
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 $691.83 Median $870.96 Typical High $2,290.87 | Professional | None | $691.83 | $870.96 | $2,290.87 |
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 $416.87 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | 54 · Surgery only | $630.96 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $87.10 |
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· 48th of 51
$871
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.