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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $213.80 | Professional | None | $77.62 | $131.83 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $1,659.59 | Facility | None | $338.84 | $630.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $323.59 | Professional | None | $74.13 | $134.90 | $323.59 |
Emblem Health Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | None | $151.36 | $229.09 | $229.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $2,630.27 | Facility | None | $524.81 | $933.25 | $2,630.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $74.13 Median $154.88 Typical High $354.81 | Professional | None | $74.13 | $154.88 | $354.81 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $288.40 | Professional | None | $61.66 | $120.23 | $288.40 |
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 $38.90 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $38.90 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $23.99 Typical High $30.20 | Professional | 53 · Discontinued | $15.49 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $91.20 Typical High $112.20 | Professional | 54 · Surgery only | $57.54 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $18.20 Typical High $22.39 | Professional | 55 · Aftercare only | $11.75 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.76 | $12.02 | $15.14 |
Where New Jersey sits
The same service costs 3.6 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· 45th of 51
$141
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.