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 $162.18 Median $3,311.31 Typical High $10,000.00 | Facility | None | $162.18 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $1,819.70 Typical High $2,344.23 | Professional | None | $131.83 | $1,819.70 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,023.29 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $426.58 Typical High $3,311.31 | Professional | None | $141.25 | $426.58 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,778.28 | $2,754.23 | $2,754.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $144.54 Median $1,778.28 Typical High $5,623.41 | Professional | None | $144.54 | $1,778.28 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,786.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $141.25 Median $1,174.90 Typical High $3,311.31 | Professional | None | $141.25 | $1,174.90 | $3,311.31 |
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 $81.28 Median $346.74 Typical High $1,174.90 | Professional | 52 · Reduced service | $81.28 | $346.74 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $138.04 Typical High $467.74 | Professional | 53 · Discontinued | $32.36 | $138.04 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $524.81 Typical High $1,778.28 | Professional | 54 · Surgery only | $120.23 | $524.81 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $104.71 Typical High $354.81 | Professional | 55 · Aftercare only | $23.99 | $104.71 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $69.18 Typical High $234.42 | Professional | 56 · Pre-op care only | $16.22 | $69.18 | $234.42 |
Where New Jersey sits
The same service costs 11.2 times more in Oklahoma 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· 24th of 51
$1,820
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.