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 $154.88 Median $3,388.44 Typical High $10,000.00 | Facility | None | $154.88 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $524.81 Typical High $851.14 | Professional | None | $154.88 | $524.81 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $162.18 | Professional | None | $128.82 | $144.54 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $891.25 Typical High $1,698.24 | Facility | None | $371.54 | $891.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $389.05 Typical High $954.99 | Professional | None | $131.83 | $389.05 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | None | $831.76 | $1,148.15 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $6,456.54 | Facility | None | $1,071.52 | $1,905.46 | $6,456.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $162.18 Median $758.58 Typical High $1,258.93 | Professional | None | $162.18 | $758.58 | $1,258.93 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $147.91 Median $549.54 Typical High $1,023.29 | Professional | None | $147.91 | $549.54 | $1,023.29 |
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 $77.62 Median $239.88 Typical High $323.59 | Professional | 52 · Reduced service | $77.62 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $95.50 Typical High $128.82 | Professional | 53 · Discontinued | $30.90 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $363.08 Typical High $478.63 | Professional | 54 · Surgery only | $117.49 | $363.08 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $72.44 Typical High $95.50 | Professional | 55 · Aftercare only | $23.44 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $47.86 Typical High $64.57 | Professional | 56 · Pre-op care only | $15.49 | $47.86 | $64.57 |
Where New Jersey sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 34th of 51
$589
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.