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 $36.31 Median $3,548.13 Typical High $10,232.93 | Facility | None | $36.31 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $95.50 Typical High $138.04 | Professional | None | $29.51 | $95.50 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $181.97 Typical High $371.54 | Facility | None | $95.50 | $181.97 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $72.44 Typical High $223.87 | Professional | None | $19.50 | $72.44 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $169.82 | Professional | None | $109.65 | $169.82 | $169.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $154.88 Median $288.40 Typical High $2,041.74 | Facility | None | $154.88 | $288.40 | $2,041.74 |
Horizon BCBS Setting Professional Modifier None Typical Low $29.51 Median $120.23 Typical High $331.13 | Professional | None | $29.51 | $120.23 | $331.13 |
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 $21.38 Median $72.44 Typical High $190.55 | Professional | None | $21.38 | $72.44 | $190.55 |
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 $15.85 Median $45.71 Typical High $69.18 | Professional | 52 · Reduced service | $15.85 | $45.71 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $18.20 Typical High $27.54 | Professional | 53 · Discontinued | $6.31 | $18.20 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $67.61 Typical High $104.71 | Professional | 54 · Surgery only | $23.99 | $67.61 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $13.80 Typical High $20.89 | Professional | 55 · Aftercare only | $4.79 | $13.80 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $9.12 Typical High $13.80 | Professional | 56 · Pre-op care only | $3.16 | $9.12 | $13.80 |
Where New Jersey sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 30th of 51
$100
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.