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 $56.23 Median $3,467.37 Typical High $10,000.00 | Facility | None | $56.23 | $3,467.37 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $138.04 | Professional | None | $54.95 | $93.33 | $138.04 |
AmeriHealth Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $12,882.50 | Facility | None | $4,786.30 | $8,317.64 | $12,882.50 |
AmeriHealth Setting Professional Modifier None Typical Low $57.54 Median $154.88 Typical High $275.42 | Professional | None | $57.54 | $154.88 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $144.54 Typical High $1,659.59 | Facility | None | $81.28 | $144.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $97.72 Typical High $213.80 | Professional | None | $47.86 | $97.72 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $165.96 | Professional | None | $109.65 | $165.96 | $165.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $109.65 Median $208.93 Typical High $933.25 | Facility | None | $109.65 | $208.93 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $245.47 | Professional | None | $48.98 | $109.65 | $245.47 |
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 $41.69 Median $85.11 Typical High $190.55 | Professional | None | $41.69 | $85.11 | $190.55 |
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 $27.54 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $27.54 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $10.96 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $40.74 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $8.13 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.51 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.50 | $8.51 | $10.72 |
Where New Jersey sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 39th of 51
$100
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.