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 $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | None | $114.82 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $288.40 | Professional | None | $85.11 | $123.03 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $181.97 | Professional | None | $128.82 | $169.82 | $181.97 |
Horizon BCBS Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $251.19 | Professional | None | $125.89 | $147.91 | $251.19 |
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 $95.50 Median $125.89 Typical High $251.19 | Professional | None | $95.50 | $125.89 | $251.19 |
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 $57.54 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $57.54 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $22.91 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $17.38 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.48 | $13.80 | $13.80 |
Where New Jersey sits
The same service costs 3.7 times more in Alaska 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· 45th of 51
$138
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.