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 $74.13 Median $154.88 Typical High $177.83 | Professional | None | $74.13 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $954.99 Typical High $1,659.59 | Facility | None | $489.78 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $275.42 | Professional | None | $63.10 | $162.18 | $275.42 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $398.11 | Professional | None | $288.40 | $398.11 | $398.11 |
Horizon BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,412.54 Typical High $3,467.37 | Facility | None | $794.33 | $1,412.54 | $3,467.37 |
Horizon BCBS Setting Professional Modifier None Typical Low $75.86 Median $218.78 Typical High $331.13 | Professional | None | $75.86 | $218.78 | $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 $50.12 Median $128.82 Typical High $204.17 | Professional | None | $50.12 | $128.82 | $204.17 |
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 $37.15 Median $75.86 Typical High $89.13 | Professional | 52 · Reduced service | $37.15 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $15.14 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $114.82 Typical High $134.90 | Professional | 54 · Surgery only | $56.23 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $11.22 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.41 | $15.49 | $17.78 |
Where New Jersey sits
The same service costs 4.1 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· 43rd 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.