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 $51.29 Median $3,311.31 Typical High $10,000.00 | Facility | None | $51.29 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $263.03 Typical High $380.19 | Professional | None | $51.29 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $109.65 Typical High $190.55 | Professional | 52 · Reduced service | $25.70 | $109.65 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $45.71 Typical High $75.86 | Professional | 53 · Discontinued | $10.23 | $45.71 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $165.96 Typical High $281.84 | Professional | 54 · Surgery only | $38.90 | $165.96 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $33.11 Typical High $57.54 | Professional | 55 · Aftercare only | $7.76 | $33.11 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $22.39 Typical High $38.02 | Professional | 56 · Pre-op care only | $5.13 | $22.39 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $125.89 Typical High $478.63 | Professional | None | $45.71 | $125.89 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | None | $295.12 | $407.38 | $407.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $45.71 Median $323.59 Typical High $588.84 | Professional | None | $45.71 | $323.59 | $588.84 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,548.13 Typical High $6,456.54 | Facility | None | $1,148.15 | $3,548.13 | $6,456.54 |
United Setting Professional Modifier None Typical Low $42.66 Median $213.80 Typical High $467.74 | Professional | None | $42.66 | $213.80 | $467.74 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 50 · Both sides | $338.84 | $338.84 | $338.84 |
Where New Jersey sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 28th of 51
$251
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.