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 $109.65 Median $4,786.30 Typical High $10,232.93 | Facility | None | $109.65 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $107.15 | $1,380.38 | $1,698.24 |
AmeriHealth Setting Facility Modifier None Typical Low $18,620.87 Median $28,840.32 Typical High $44,668.36 | Facility | None | $18,620.87 | $28,840.32 | $44,668.36 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $5,248.07 | Facility | None | $1,995.26 | $3,019.95 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $263.03 Typical High $2,454.71 | Professional | None | $74.13 | $263.03 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $2,290.87 | Professional | None | $1,288.25 | $2,137.96 | $2,290.87 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $7,244.36 Typical High $16,218.10 | Facility | None | $4,073.80 | $7,244.36 | $16,218.10 |
Horizon BCBS Setting Professional Modifier None Typical Low $93.33 Median $2,089.30 Typical High $3,890.45 | Professional | None | $93.33 | $2,089.30 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $87.10 Median $977.24 Typical High $3,388.44 | Professional | None | $87.10 | $977.24 | $3,388.44 |
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 $53.70 Median $223.87 Typical High $758.58 | Professional | 52 · Reduced service | $53.70 | $223.87 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $89.13 Typical High $302.00 | Professional | 53 · Discontinued | $21.38 | $89.13 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $338.84 Typical High $1,148.15 | Professional | 54 · Surgery only | $81.28 | $338.84 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $67.61 Typical High $229.09 | Professional | 55 · Aftercare only | $16.22 | $67.61 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $44.67 Typical High $151.36 | Professional | 56 · Pre-op care only | $10.72 | $44.67 | $151.36 |
Where New Jersey sits
The same service costs 19.1 times more in Alaska 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· 21st of 51
$1,514
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.