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 $79.43 Median $3,311.31 Typical High $10,000.00 | Facility | None | $79.43 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $245.47 | Professional | None | $77.62 | $177.83 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $162.18 | Professional | None | $60.26 | $75.86 | $162.18 |
AmeriHealth Setting Facility Modifier None Typical Low $3,467.37 Median $5,754.40 Typical High $8,317.64 | Facility | None | $3,467.37 | $5,754.40 | $8,317.64 |
AmeriHealth Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $537.03 | Professional | None | $446.68 | $478.63 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $128.82 Typical High $309.03 | Professional | None | $54.95 | $128.82 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $295.12 | Professional | None | $204.17 | $275.42 | $295.12 |
Horizon BCBS Setting Professional Modifier None Typical Low $69.18 Median $218.78 Typical High $371.54 | Professional | None | $69.18 | $218.78 | $371.54 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,148.15 | $3,311.31 | $5,888.44 |
United Setting Professional Modifier None Typical Low $64.57 Median $165.96 Typical High $275.42 | Professional | None | $64.57 | $165.96 | $275.42 |
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 $39.81 Median $77.62 Typical High $123.03 | Professional | 52 · Reduced service | $39.81 | $77.62 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $30.90 Typical High $48.98 | Professional | 53 · Discontinued | $15.85 | $30.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $114.82 Typical High $181.97 | Professional | 54 · Surgery only | $60.26 | $114.82 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $22.91 Typical High $36.31 | Professional | 55 · Aftercare only | $12.02 | $22.91 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $15.49 Typical High $24.55 | Professional | 56 · Pre-op care only | $7.94 | $15.49 | $24.55 |
Where New Jersey sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 44th of 51
$145
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.