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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | None | $186.21 | $186.21 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $6,456.54 | Facility | None | $2,511.89 | $3,981.07 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $501.19 | Professional | None | $128.82 | $223.87 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $245.47 | Professional | None | $169.82 | $245.47 | $245.47 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $7,244.36 Typical High $16,218.10 | Facility | None | $3,981.07 | $7,244.36 | $16,218.10 |
Horizon BCBS Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $537.03 | Professional | None | $218.78 | $223.87 | $537.03 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $426.58 | Professional | None | $125.89 | $190.55 | $426.58 |
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 $93.33 Median $93.33 Typical High $102.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $37.15 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 54 · Surgery only | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $20.89 |
Where New Jersey sits
The same service costs 10.2 times more in Oklahoma 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· 38th of 51
$257
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.