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 $60.26 Median $3,388.44 Typical High $10,000.00 | Facility | None | $60.26 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $87.10 | Professional | None | $54.95 | $74.13 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $102.33 Typical High $1,659.59 | Facility | None | $57.54 | $102.33 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $120.23 | Professional | None | $39.81 | $52.48 | $120.23 |
Emblem Health Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | None | $91.20 | $125.89 | $125.89 |
Horizon BCBS Setting Facility Modifier None Typical Low $79.43 Median $147.91 Typical High $6,309.57 | Facility | None | $79.43 | $147.91 | $6,309.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $134.90 | Professional | None | $54.95 | $91.20 | $134.90 |
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 $35.48 Median $52.48 Typical High $77.62 | Professional | None | $35.48 | $52.48 | $77.62 |
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 $27.54 Median $36.31 Typical High $43.65 | Professional | 52 · Reduced service | $27.54 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.45 Typical High $17.38 | Professional | 53 · Discontinued | $10.96 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $53.70 Typical High $64.57 | Professional | 54 · Surgery only | $40.74 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $8.13 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.50 | $7.24 | $8.71 |
Where New Jersey sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 51st of 51
$56.23
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.