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 $53.70 Median $4,365.16 Typical High $10,471.29 | Facility | None | $53.70 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $100.00 Typical High $128.82 | Professional | None | $44.67 | $100.00 | $128.82 |
AmeriHealth Setting Professional Modifier None Typical Low $85.11 Median $239.88 Typical High $416.87 | Professional | None | $85.11 | $239.88 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $1,659.59 | Facility | None | $141.25 | $251.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $91.20 Typical High $165.96 | Professional | None | $37.15 | $91.20 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $12.30 Median $83.18 Typical High $245.47 | Professional | None | $12.30 | $83.18 | $245.47 |
Horizon BCBS Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $3,801.89 | Facility | None | $173.78 | $316.23 | $3,801.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $44.67 Median $131.83 Typical High $190.55 | Professional | None | $44.67 | $131.83 | $190.55 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $28.18 Median $72.44 Typical High $125.89 | Professional | None | $28.18 | $72.44 | $125.89 |
6 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 $22.39 Median $50.12 Typical High $63.10 | Professional | 52 · Reduced service | $22.39 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $19.95 Typical High $25.12 | Professional | 53 · Discontinued | $8.91 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $74.13 Typical High $93.33 | Professional | 54 · Surgery only | $33.11 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $6.76 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.47 | $10.00 | $12.59 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 33 · Preventive service | $43.65 | $43.65 | $43.65 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 41st of 51
$91.20
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.