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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | None | $50.12 | $50.12 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $50.12 Typical High $134.90 | Professional | None | $30.20 | $50.12 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $74.13 | Professional | None | $51.29 | $72.44 | $74.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $616.60 | Facility | None | $295.12 | $446.68 | $616.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $151.36 | Professional | None | $44.67 | $52.48 | $151.36 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,801.89 | Facility | None | $309.03 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $141.25 | Professional | None | $42.66 | $56.23 | $141.25 |
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 $25.12 Median $25.12 Typical High $28.18 | Professional | 52 · Reduced service | $25.12 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $11.22 | Professional | 53 · Discontinued | $10.00 | $10.00 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | 54 · Surgery only | $38.02 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $8.51 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.62 |
Where New Jersey sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 37th of 51
$67.61
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.