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 $104.71 Median $3,630.78 Typical High $10,000.00 | Facility | None | $104.71 | $3,630.78 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $234.42 | Professional | None | $85.11 | $181.97 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,905.46 Typical High $3,162.28 | Facility | None | $691.83 | $1,905.46 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $251.19 | Professional | None | $81.28 | $154.88 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $28.84 Median $138.04 Typical High $389.05 | Professional | None | $28.84 | $138.04 | $389.05 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $4,073.80 Typical High $10,471.29 | Facility | None | $2,290.87 | $4,073.80 | $10,471.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $316.23 | Professional | None | $91.20 | $204.17 | $316.23 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $208.93 | Professional | None | $60.26 | $134.90 | $208.93 |
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 $42.66 Median $75.86 Typical High $117.49 | Professional | 52 · Reduced service | $42.66 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $30.90 Typical High $46.77 | Professional | 53 · Discontinued | $16.98 | $30.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $64.57 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $12.88 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $15.14 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.51 | $15.14 | $23.44 |
Where New Jersey sits
The same service costs 4.0 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· 47th of 51
$151
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.