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 $38.90 Median $3,311.31 Typical High $10,000.00 | Facility | None | $38.90 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $117.49 Typical High $213.80 | Professional | None | $38.90 | $117.49 | $213.80 |
AmeriHealth Setting Facility Modifier None Typical Low $831.76 Median $6,025.60 Typical High $10,471.29 | Facility | None | $831.76 | $6,025.60 | $10,471.29 |
AmeriHealth Setting Professional Modifier None Typical Low $16.22 Median $32.36 Typical High $67.61 | Professional | None | $16.22 | $32.36 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $95.50 Typical High $245.47 | Professional | None | $29.51 | $95.50 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $288.40 | Professional | None | $204.17 | $281.84 | $288.40 |
Horizon BCBS Setting Professional Modifier None Typical Low $36.31 Median $181.97 Typical High $331.13 | Professional | None | $36.31 | $181.97 | $331.13 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,148.15 | $3,311.31 | $5,888.44 |
United Setting Professional Modifier None Typical Low $22.91 Median $97.72 Typical High $229.09 | Professional | None | $22.91 | $97.72 | $229.09 |
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 $19.05 Median $58.88 Typical High $83.18 | Professional | 52 · Reduced service | $19.05 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $23.44 Typical High $33.11 | Professional | 53 · Discontinued | $7.76 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $87.10 Typical High $125.89 | Professional | 54 · Surgery only | $28.84 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $17.38 Typical High $25.12 | Professional | 55 · Aftercare only | $5.75 | $17.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $11.75 Typical High $16.60 | Professional | 56 · Pre-op care only | $3.89 | $11.75 | $16.60 |
Where New Jersey sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 42nd 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.