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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $173.78 | Professional | None | $141.25 | $158.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,174.90 | $3,801.89 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $338.84 | Professional | None | $91.20 | $147.91 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $199.53 | Professional | None | $147.91 | $194.98 | $199.53 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,585.78 Typical High $22,387.21 | Facility | None | $4,168.69 | $7,585.78 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $389.05 | Professional | None | $131.83 | $154.88 | $389.05 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,897.79 | $11,220.18 |
United Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $416.87 | Professional | None | $123.03 | $162.18 | $416.87 |
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 $70.79 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $70.79 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $28.18 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $20.89 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $15.85 |
Where New Jersey sits
The same service costs 20.4 times more in Kansas 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· 30th of 51
$263
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.