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 $97.72 Median $4,365.16 Typical High $10,471.29 | Facility | None | $97.72 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $407.38 Typical High $478.63 | Professional | None | $97.72 | $407.38 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $724.44 Typical High $2,691.53 | Facility | None | $398.11 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $229.09 Typical High $676.08 | Professional | None | $61.66 | $229.09 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $602.56 | Professional | None | $389.05 | $602.56 | $602.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,000.00 Typical High $2,344.23 | Facility | None | $562.34 | $1,000.00 | $2,344.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $87.10 Median $524.81 Typical High $1,202.26 | Professional | None | $87.10 | $524.81 | $1,202.26 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $81.28 Median $288.40 Typical High $776.25 | Professional | None | $81.28 | $288.40 | $776.25 |
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 $48.98 Median $173.78 Typical High $239.88 | Professional | 52 · Reduced service | $48.98 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $69.18 Typical High $95.50 | Professional | 53 · Discontinued | $19.50 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $263.03 Typical High $354.81 | Professional | 54 · Surgery only | $72.44 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $52.48 Typical High $70.79 | Professional | 55 · Aftercare only | $14.45 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $34.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $9.77 | $34.67 | $47.86 |
Where New Jersey sits
The same service costs 7.8 times more in Oklahoma 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· 16th of 51
$468
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.