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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | None | $125.89 | $125.89 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,691.53 Typical High $4,570.88 | Facility | None | $691.83 | $2,691.53 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $288.40 | Professional | None | $75.86 | $117.49 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $158.49 | Professional | None | $104.71 | $158.49 | $158.49 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,786.30 Typical High $11,748.98 | Facility | None | $2,754.23 | $4,786.30 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $363.08 | Professional | None | $109.65 | $128.82 | $363.08 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $346.74 | Professional | None | $102.33 | $125.89 | $346.74 |
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 $63.10 Median $63.10 Typical High $69.18 | Professional | 52 · Reduced service | $63.10 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $28.18 | Professional | 53 · Discontinued | $25.12 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | 54 · Surgery only | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $20.89 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $14.13 |
Where New Jersey sits
The same service costs 12.9 times more in Arkansas than in New York. 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· 28th of 51
$219
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.