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 $257.04 Median $4,466.84 Typical High $9,772.37 | Facility | None | $257.04 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $1,000.00 Typical High $1,318.26 | Professional | None | $257.04 | $1,000.00 | $1,318.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $398.11 Typical High $645.65 | Professional | 52 · Reduced service | $128.82 | $398.11 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $158.49 Typical High $257.04 | Professional | 53 · Discontinued | $51.29 | $158.49 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $602.56 Typical High $954.99 | Professional | 54 · Surgery only | $190.55 | $602.56 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $120.23 Typical High $190.55 | Professional | 55 · Aftercare only | $38.90 | $120.23 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $79.43 Typical High $128.82 | Professional | 56 · Pre-op care only | $25.70 | $79.43 | $128.82 |
AmeriHealth Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $616.60 Typical High $1,698.24 | Professional | None | $204.17 | $616.60 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,778.28 | $1,778.28 |
Horizon BCBS Setting Professional Modifier None Typical Low $199.53 Median $1,174.90 Typical High $2,089.30 | Professional | None | $199.53 | $1,174.90 | $2,089.30 |
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 $190.55 Median $660.69 Typical High $1,737.80 | Professional | None | $190.55 | $660.69 | $1,737.80 |
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 59 · Distinct service Typical Low $165.96 Median $194.98 Typical High $1,412.54 | Professional | 59 · Distinct service | $165.96 | $194.98 | $1,412.54 |
Where New Jersey sits
The same service costs 4.1 times more in Washington 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· 26th of 51
$933
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.