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 $15.85 Median $33.11 Typical High $42.66 | Facility | None | $15.85 | $33.11 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $30.90 Typical High $34.67 | Professional | None | $15.85 | $30.90 | $34.67 |
AmeriHealth Setting Facility Modifier None Typical Low $23.44 Median $2,570.40 Typical High $4,786.30 | Facility | None | $23.44 | $2,570.40 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $23.99 Typical High $56.23 | Professional | None | $12.30 | $23.99 | $56.23 |
Emblem Health Setting Professional Modifier None Typical Low $25.70 Median $41.69 Typical High $44.67 | Professional | None | $25.70 | $41.69 | $44.67 |
Horizon BCBS Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $758.58 | Facility | None | $295.12 | $489.78 | $758.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $14.45 Median $31.62 Typical High $87.10 | Professional | None | $14.45 | $31.62 | $87.10 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,801.89 | Facility | None | $309.03 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $13.80 Median $28.84 Typical High $52.48 | Professional | None | $13.80 | $28.84 | $52.48 |
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 $7.94 Median $13.18 Typical High $16.98 | Professional | 52 · Reduced service | $7.94 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.25 Typical High $6.76 | Professional | 53 · Discontinued | $3.16 | $5.25 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $20.42 Typical High $25.12 | Professional | 54 · Surgery only | $12.02 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $3.98 Typical High $5.01 | Professional | 55 · Aftercare only | $2.40 | $3.98 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.63 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.58 | $2.63 | $3.39 |
Where New Jersey sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 37th of 51
$32.36
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.