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 $58.88 Median $97.72 Typical High $131.83 | Professional | None | $58.88 | $97.72 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $1,659.59 | Facility | None | $141.25 | $251.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $295.12 | Professional | None | $66.07 | $154.88 | $295.12 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $275.42 | Professional | None | $177.83 | $275.42 | $275.42 |
Horizon BCBS Setting Facility Modifier None Typical Low $194.98 Median $371.54 Typical High $933.25 | Facility | None | $194.98 | $371.54 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $69.18 Median $162.18 Typical High $323.59 | Professional | None | $69.18 | $162.18 | $323.59 |
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 $53.70 Median $123.03 Typical High $269.15 | Professional | None | $53.70 | $123.03 | $269.15 |
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 $29.51 Median $48.98 Typical High $66.07 | Professional | 52 · Reduced service | $29.51 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $11.75 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $72.44 Typical High $100.00 | Professional | 54 · Surgery only | $44.67 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $14.45 Typical High $19.95 | Professional | 55 · Aftercare only | $8.91 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.89 | $9.77 | $13.18 |
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· 32nd of 51
$148
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.