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 $3,162.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $3,162.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | None | $109.65 | $109.65 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,370.32 Typical High $9,772.37 | Facility | None | $1,023.29 | $5,370.32 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $213.80 | Professional | None | $77.62 | $93.33 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $194.98 | Professional | None | $131.83 | $173.78 | $194.98 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $4,168.69 Typical High $22,908.68 | Facility | None | $2,187.76 | $4,168.69 | $22,908.68 |
Horizon BCBS Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $169.82 | Professional | None | $109.65 | $131.83 | $169.82 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $125.89 | Professional | None | $67.61 | $83.18 | $125.89 |
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 $54.95 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $23.99 | Professional | 53 · Discontinued | $21.88 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $12.02 |
Where New Jersey sits
The same service costs 4.8 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· 48th of 51
$110
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.