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 $1,096.48 Median $1,096.48 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,096.48 | $2,187.76 |
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 $1,819.70 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,819.70 | $1,819.70 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $4,466.84 Typical High $4,466.84 | Professional | None | $2,041.74 | $4,466.84 | $4,466.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $6,606.93 | Professional | None | $2,238.72 | $2,630.27 | $6,606.93 |
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 $1,778.28 Median $3,235.94 Typical High $7,079.46 | Professional | None | $1,778.28 | $3,235.94 | $7,079.46 |
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 $549.54 Median $549.54 Typical High $1,096.48 | Professional | 52 · Reduced service | $549.54 | $549.54 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $446.68 | Professional | 53 · Discontinued | $218.78 | $218.78 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,659.59 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $331.13 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $218.78 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $218.78 |
Where New Jersey sits
The same service costs 4.7 times more in Alaska than in South Carolina. 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· 34th of 51
$2,239
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.