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 $47.86 Median $3,388.44 Typical High $10,000.00 | Facility | None | $47.86 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $72.44 Typical High $112.20 | Professional | None | $33.11 | $72.44 | $112.20 |
AmeriHealth Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $239.88 | Professional | None | $89.13 | $151.36 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $354.81 | Facility | None | $64.57 | $112.20 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $72.44 Typical High $190.55 | Professional | None | $27.54 | $72.44 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | None | $85.11 | $128.82 | $128.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $97.72 Median $177.83 Typical High $933.25 | Facility | None | $97.72 | $177.83 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $28.84 Median $87.10 Typical High $213.80 | Professional | None | $28.84 | $87.10 | $213.80 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $22.91 Median $66.07 Typical High $147.91 | Professional | None | $22.91 | $66.07 | $147.91 |
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 $17.78 Median $33.88 Typical High $44.67 | Professional | 52 · Reduced service | $17.78 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $13.49 Typical High $18.20 | Professional | 53 · Discontinued | $7.08 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $51.29 Typical High $67.61 | Professional | 54 · Surgery only | $26.92 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $10.23 Typical High $13.49 | Professional | 55 · Aftercare only | $5.37 | $10.23 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $6.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.55 | $6.76 | $9.12 |
Where New Jersey sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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
$75.86
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.