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 $977.24 Median $977.24 Typical High $1,862.09 | Professional | None | $977.24 | $977.24 | $1,862.09 |
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 $1,513.56 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,513.56 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $3,548.13 Typical High $3,548.13 | Professional | None | $1,412.54 | $3,548.13 | $3,548.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $10,000.00 | Facility | None | $9,549.93 | $9,549.93 | $10,000.00 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $5,495.41 | Professional | None | $1,862.09 | $2,187.76 | $5,495.41 |
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 $1,380.38 Median $2,570.40 Typical High $5,888.44 | Professional | None | $1,380.38 | $2,570.40 | $5,888.44 |
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 $489.78 Median $489.78 Typical High $912.01 | Professional | 52 · Reduced service | $489.78 | $489.78 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $371.54 | Professional | 53 · Discontinued | $194.98 | $194.98 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $1,380.38 | Professional | 54 · Surgery only | $724.44 | $724.44 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $275.42 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $186.21 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $186.21 |
Where New Jersey sits
The same service costs 4.7 times more in Alaska than in Arkansas. 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· 30th of 51
$1,862
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.