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 $2,570.40 Median $4,897.79 Typical High $10,964.78 | Facility | None | $2,570.40 | $4,897.79 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $245.47 | Professional | None | $102.33 | $194.98 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $1,778.28 | Facility | None | $549.54 | $1,096.48 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $275.42 | Professional | None | $87.10 | $154.88 | $275.42 |
Emblem Health Setting Professional Modifier None Typical Low $40.74 Median $123.03 Typical High $398.11 | Professional | None | $40.74 | $123.03 | $398.11 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $4,466.84 | Facility | None | $1,000.00 | $1,862.09 | $4,466.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $331.13 | Professional | None | $104.71 | $229.09 | $331.13 |
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 $66.07 Median $138.04 Typical High $213.80 | Professional | None | $66.07 | $138.04 | $213.80 |
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 $51.29 Median $83.18 Typical High $123.03 | Professional | 52 · Reduced service | $51.29 | $83.18 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $33.11 Typical High $50.12 | Professional | 53 · Discontinued | $20.42 | $33.11 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $125.89 Typical High $186.21 | Professional | 54 · Surgery only | $75.86 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $25.12 Typical High $37.15 | Professional | 55 · Aftercare only | $15.14 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.60 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.23 | $16.60 | $24.55 |
Where New Jersey sits
The same service costs 3.8 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· 48th of 51
$155
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.