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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | None | $218.78 | $218.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,071.52 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $389.05 | Professional | None | $158.49 | $190.55 | $389.05 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $389.05 | Professional | None | $263.03 | $338.84 | $389.05 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,019.95 | $3,981.07 |
Horizon BCBS Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $363.08 | Professional | None | $234.42 | $275.42 | $363.08 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $263.03 | Professional | None | $134.90 | $169.82 | $263.03 |
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 $109.65 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $44.67 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | 54 · Surgery only | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $36.31 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $23.99 |
Where New Jersey sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$219
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.