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 $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $245.47 | Professional | None | $107.15 | $204.17 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,187.76 | Facility | None | $645.65 | $1,202.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $436.52 | Professional | None | $87.10 | $194.98 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $426.58 | Professional | None | $281.84 | $426.58 | $426.58 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,949.84 Typical High $5,888.44 | Facility | None | $1,071.52 | $1,949.84 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $104.71 Median $288.40 Typical High $645.65 | Professional | None | $104.71 | $288.40 | $645.65 |
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 $102.33 Median $234.42 Typical High $446.68 | Professional | None | $102.33 | $234.42 | $446.68 |
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 $89.13 Typical High $114.82 | Professional | 52 · Reduced service | $53.70 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $35.48 Typical High $45.71 | Professional | 53 · Discontinued | $21.38 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $131.83 Typical High $173.78 | Professional | 54 · Surgery only | $79.43 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $26.30 Typical High $34.67 | Professional | 55 · Aftercare only | $15.85 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $17.78 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.72 | $17.78 | $22.91 |
Where New Jersey sits
The same service costs 4.3 times more in Alaska 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· 30th of 51
$282
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.