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 $70.79 Median $79.43 Typical High $79.43 | Facility | None | $70.79 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | None | $70.79 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,288.25 Typical High $2,754.23 | Facility | None | $489.78 | $1,288.25 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $186.21 | Professional | None | $46.77 | $77.62 | $186.21 |
Emblem Health Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $95.50 | Professional | None | $69.18 | $95.50 | $95.50 |
Horizon BCBS Setting Facility Modifier None Typical Low $346.74 Median $645.65 Typical High $1,659.59 | Facility | None | $346.74 | $645.65 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $194.98 | Professional | None | $69.18 | $72.44 | $194.98 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $151.36 | Professional | None | $47.86 | $70.79 | $151.36 |
4 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 $35.48 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $35.48 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $14.13 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $10.72 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.08 | $7.94 | $7.94 |
Where New Jersey sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 46th of 51
$79.43
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.