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 $46.77 Median $53.70 Typical High $53.70 | Facility | None | $46.77 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $53.70 | Professional | None | $46.77 | $53.70 | $53.70 |
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 $30.90 Median $51.29 Typical High $123.03 | Professional | None | $30.90 | $51.29 | $123.03 |
Emblem Health Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $63.10 | Professional | None | $44.67 | $63.10 | $63.10 |
Horizon BCBS Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $1,778.28 | Facility | None | $363.08 | $645.65 | $1,778.28 |
Horizon BCBS Setting Professional Modifier None Typical Low $45.71 Median $48.98 Typical High $128.82 | Professional | None | $45.71 | $48.98 | $128.82 |
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 $31.62 Median $46.77 Typical High $102.33 | Professional | None | $31.62 | $46.77 | $102.33 |
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 $23.44 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $9.33 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.68 | $5.37 | $5.37 |
Where New Jersey sits
The same service costs 4.7 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
$53.70
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.