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 $64.57 Median $120.23 Typical High $144.54 | Professional | None | $64.57 | $120.23 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $309.03 Typical High $2,691.53 | Facility | None | $165.96 | $309.03 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $120.23 Typical High $199.53 | Professional | None | $48.98 | $120.23 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $302.00 | Professional | None | $218.78 | $302.00 | $302.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $239.88 Median $426.58 Typical High $4,466.84 | Facility | None | $239.88 | $426.58 | $4,466.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $60.26 Median $173.78 Typical High $251.19 | Professional | None | $60.26 | $173.78 | $251.19 |
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 $40.74 Median $102.33 Typical High $154.88 | Professional | None | $40.74 | $102.33 | $154.88 |
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 $32.36 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $32.36 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $12.88 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $47.86 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $9.55 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.46 | $11.22 | $12.88 |
Where New Jersey sits
The same service costs 3.7 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
$117
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.