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 $42.66 Median $4,786.30 Typical High $10,471.29 | Facility | None | $42.66 | $4,786.30 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Professional | None | $39.81 | $39.81 | $48.98 |
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 $26.30 Median $36.31 Typical High $100.00 | Professional | None | $26.30 | $36.31 | $100.00 |
Emblem Health Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $51.29 | Professional | None | $35.48 | $51.29 | $51.29 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,513.56 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $114.82 | Professional | None | $38.02 | $44.67 | $114.82 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $117.49 | Professional | None | $33.11 | $42.66 | $117.49 |
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 $19.95 Median $19.95 Typical High $22.39 | Professional | 52 · Reduced service | $19.95 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $8.91 | Professional | 53 · Discontinued | $7.94 | $7.94 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $30.20 Typical High $33.88 | Professional | 54 · Surgery only | $30.20 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.76 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.47 |
Where New Jersey sits
The same service costs 9.3 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· 44th of 51
$52.48
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.