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 $54.95 Median $4,466.84 Typical High $9,772.37 | Facility | None | $54.95 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $117.49 Typical High $181.97 | Professional | None | $51.29 | $117.49 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
AmeriHealth Setting Facility Modifier None Typical Low $1,122.02 Median $2,290.87 Typical High $8,317.64 | Facility | None | $1,122.02 | $2,290.87 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $112.20 Typical High $223.87 | Professional | None | $45.71 | $112.20 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $186.21 | Professional | None | $134.90 | $181.97 | $186.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $45.71 Median $162.18 Typical High $281.84 | Professional | None | $45.71 | $162.18 | $281.84 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,148.15 | $3,311.31 | $5,888.44 |
United Setting Professional Modifier None Typical Low $42.66 Median $114.82 Typical High $234.42 | Professional | None | $42.66 | $114.82 | $234.42 |
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 $27.54 Median $57.54 Typical High $91.20 | Professional | 52 · Reduced service | $27.54 | $57.54 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $23.44 Typical High $36.31 | Professional | 53 · Discontinued | $10.96 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $87.10 Typical High $138.04 | Professional | 54 · Surgery only | $41.69 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $17.38 Typical High $27.54 | Professional | 55 · Aftercare only | $8.32 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $11.48 Typical High $18.20 | Professional | 56 · Pre-op care only | $5.50 | $11.48 | $18.20 |
Where New Jersey sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 32nd of 51
$117
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.