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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $691.83 | Professional | None | $251.19 | $251.19 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $3,981.07 | Facility | None | $1,698.24 | $2,691.53 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $1,071.52 | Professional | None | $234.42 | $363.08 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,000.00 | Professional | None | $691.83 | $933.25 | $1,000.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,818.38 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,621.81 | Professional | None | $616.60 | $707.95 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,818.38 | $6,760.83 |
United Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,513.56 | Professional | None | $446.68 | $630.96 | $1,513.56 |
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 $125.89 Median $125.89 Typical High $331.13 | Professional | 52 · Reduced service | $125.89 | $125.89 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $131.83 | Professional | 53 · Discontinued | $50.12 | $50.12 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $478.63 | Professional | 54 · Surgery only | $190.55 | $190.55 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $97.72 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $66.07 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $66.07 |
Where New Jersey sits
The same service costs 53.7 times more in Alaska 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· 34th of 51
$794
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.