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 $120.23 Median $134.90 Typical High $138.04 | Professional | None | $120.23 | $134.90 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $512.86 Typical High $1,659.59 | Facility | None | $295.12 | $512.86 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $199.53 | Professional | None | $81.28 | $97.72 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $199.53 | Professional | None | $134.90 | $177.83 | $199.53 |
Horizon BCBS Setting Facility Modifier None Typical Low $380.19 Median $707.95 Typical High $1,659.59 | Facility | None | $380.19 | $707.95 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $186.21 | Professional | None | $120.23 | $141.25 | $186.21 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,890.45 | Facility | None | $309.03 | $1,380.38 | $3,890.45 |
United Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $162.18 | Professional | None | $102.33 | $120.23 | $162.18 |
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 $60.26 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $60.26 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $23.99 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 54 · Surgery only | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.02 | $13.49 | $13.49 |
Where New Jersey sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 45th of 51
$132
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.