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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | None | $97.72 | $97.72 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,023.29 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $173.78 | Professional | None | $70.79 | $85.11 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $169.82 | Professional | None | $112.20 | $147.91 | $169.82 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $158.49 | Professional | None | $102.33 | $120.23 | $158.49 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $114.82 | Professional | None | $58.88 | $75.86 | $114.82 |
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 $48.98 Median $48.98 Typical High $53.70 | Professional | 52 · Reduced service | $48.98 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $21.88 | Professional | 53 · Discontinued | $19.50 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | 54 · Surgery only | $74.13 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $16.22 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.72 |
Where New Jersey sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 51st of 51
$97.72
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.