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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | None | $100.00 | $100.00 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $524.81 Typical High $2,691.53 | Facility | None | $281.84 | $524.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $162.18 | Professional | None | $69.18 | $85.11 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $151.36 | Professional | None | $104.71 | $138.04 | $151.36 |
Horizon BCBS Setting Facility Modifier None Typical Low $380.19 Median $691.83 Typical High $1,659.59 | Facility | None | $380.19 | $691.83 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $162.18 | Professional | None | $104.71 | $123.03 | $162.18 |
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 $79.43 Median $100.00 Typical High $123.03 | Professional | None | $79.43 | $100.00 | $123.03 |
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 $50.12 Median $50.12 Typical High $52.48 | Professional | 52 · Reduced service | $50.12 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | 53 · Discontinued | $19.95 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | 54 · Surgery only | $74.13 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.85 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.72 |
Where New Jersey sits
The same service costs 4.8 times more in Alaska 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· 47th of 51
$105
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.