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 $123.03 Median $4,365.16 Typical High $10,471.29 | Facility | None | $123.03 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $295.12 | Professional | None | $120.23 | $208.93 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $3,630.78 | Facility | None | $1,023.29 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $407.38 | Professional | None | $63.10 | $162.18 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $346.74 | Professional | None | $229.09 | $346.74 | $346.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $11,748.98 | Facility | None | $2,691.53 | $4,786.30 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $660.69 | Professional | None | $79.43 | $218.78 | $660.69 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $4,168.69 | Facility | None | $537.03 | $1,548.82 | $4,168.69 |
United Setting Professional Modifier None Typical Low $79.43 Median $186.21 Typical High $426.58 | Professional | None | $79.43 | $186.21 | $426.58 |
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 $61.66 Median $87.10 Typical High $147.91 | Professional | 52 · Reduced service | $61.66 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $58.88 | Professional | 53 · Discontinued | $24.55 | $34.67 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $131.83 Typical High $218.78 | Professional | 54 · Surgery only | $93.33 | $131.83 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $43.65 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $29.51 |
Where New Jersey sits
The same service costs 4.1 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· 25th of 51
$275
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.