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 $295.12 Median $295.12 Typical High $426.58 | Professional | None | $295.12 | $295.12 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $6,025.60 | Facility | None | $691.83 | $3,162.28 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $933.25 | Professional | None | $309.03 | $398.11 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $489.78 | Professional | None | $331.13 | $489.78 | $489.78 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,413.10 Typical High $19,952.62 | Facility | None | $4,168.69 | $7,413.10 | $19,952.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $933.25 | Professional | None | $338.84 | $398.11 | $933.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $851.14 | Professional | None | $234.42 | $331.13 | $851.14 |
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 $147.91 Median $147.91 Typical High $213.80 | Professional | 52 · Reduced service | $147.91 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $87.10 | Professional | 53 · Discontinued | $58.88 | $58.88 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $323.59 | Professional | 54 · Surgery only | $218.78 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $64.57 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $42.66 |
Where New Jersey sits
The same service costs 7.8 times more in Oklahoma than in New York. 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· 41st of 51
$457
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.