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 $112.20 Median $112.20 Typical High $125.89 | Professional | None | $112.20 | $112.20 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,318.26 Typical High $2,691.53 | Facility | None | $707.95 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $208.93 | Professional | None | $85.11 | $87.10 | $208.93 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $524.81 | Professional | None | $281.84 | $354.81 | $524.81 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,949.84 Typical High $6,309.57 | Facility | None | $1,096.48 | $1,949.84 | $6,309.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $181.97 | Professional | None | $114.82 | $138.04 | $181.97 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $128.82 | Professional | None | $72.44 | $87.10 | $128.82 |
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 $56.23 Median $56.23 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $25.12 | Professional | 53 · Discontinued | $22.39 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $12.59 |
Where New Jersey sits
The same service costs 6.0 times more in Alaska 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· 49th of 51
$112
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.