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 $158.49 Median $4,786.30 Typical High $10,232.93 | Facility | None | $158.49 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $1,548.82 Typical High $2,754.23 | Professional | None | $158.49 | $1,548.82 | $2,754.23 |
Ambetter Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $6,456.54 | Facility | None | $1,202.26 | $1,995.26 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $398.11 Typical High $2,818.38 | Professional | None | $120.23 | $398.11 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,445.44 | $2,238.72 | $2,238.72 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $7,762.47 | Facility | None | $1,659.59 | $3,019.95 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $144.54 Median $1,905.46 Typical High $4,677.35 | Professional | None | $144.54 | $1,905.46 | $4,677.35 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $141.25 Median $1,023.29 Typical High $3,019.95 | Professional | None | $141.25 | $1,023.29 | $3,019.95 |
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 $79.43 Median $354.81 Typical High $954.99 | Professional | 52 · Reduced service | $79.43 | $354.81 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $309.03 Typical High $380.19 | Professional | 53 · Discontinued | $32.36 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $524.81 Typical High $1,412.54 | Professional | 54 · Surgery only | $120.23 | $524.81 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $234.42 Typical High $288.40 | Professional | 55 · Aftercare only | $23.99 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $154.88 Typical High $190.55 | Professional | 56 · Pre-op care only | $15.85 | $154.88 | $190.55 |
Where New Jersey sits
The same service costs 8.5 times more in Wisconsin than in Nebraska. 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· 11th of 51
$1,622
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.