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 $275.42 Median $4,466.84 Typical High $9,772.37 | Facility | None | $275.42 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $1,000.00 Typical High $1,513.56 | Professional | None | $251.19 | $1,000.00 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $1,000.00 Typical High $1,288.25 | Professional | None | $114.82 | $1,000.00 | $1,288.25 |
AmeriHealth Setting Facility Modifier None Typical Low $2,344.23 Median $6,309.57 Typical High $9,332.54 | Facility | None | $2,344.23 | $6,309.57 | $9,332.54 |
AmeriHealth Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $407.38 | Professional | None | $100.00 | $199.53 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $630.96 Typical High $1,995.26 | Professional | None | $223.87 | $630.96 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,995.26 | $1,995.26 |
Horizon BCBS Setting Professional Modifier None Typical Low $223.87 Median $1,445.44 Typical High $2,570.40 | Professional | None | $223.87 | $1,445.44 | $2,570.40 |
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 $208.93 Median $812.83 Typical High $2,041.74 | Professional | None | $208.93 | $812.83 | $2,041.74 |
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 $134.90 Median $489.78 Typical High $758.58 | Professional | 52 · Reduced service | $134.90 | $489.78 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $194.98 Typical High $302.00 | Professional | 53 · Discontinued | $53.70 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $724.44 Typical High $1,122.02 | Professional | 54 · Surgery only | $204.17 | $724.44 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $147.91 Typical High $223.87 | Professional | 55 · Aftercare only | $40.74 | $147.91 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $97.72 Typical High $151.36 | Professional | 56 · Pre-op care only | $26.92 | $97.72 | $151.36 |
Where New Jersey sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 39th of 51
$851
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.