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 $33.88 Median $61.66 Typical High $114.82 | Professional | None | $33.88 | $61.66 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $107.15 Typical High $354.81 | Facility | None | $61.66 | $107.15 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $177.83 | Professional | None | $38.90 | $74.13 | $177.83 |
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 $83.18 Median $158.49 Typical High $524.81 | Facility | None | $83.18 | $158.49 | $524.81 |
Horizon BCBS Setting Professional Modifier None Typical Low $39.81 Median $83.18 Typical High $181.97 | Professional | None | $39.81 | $83.18 | $181.97 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,801.89 | Facility | None | $309.03 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $31.62 Median $64.57 Typical High $144.54 | Professional | None | $31.62 | $64.57 | $144.54 |
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 $16.98 Median $30.90 Typical High $40.74 | Professional | 52 · Reduced service | $16.98 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $12.30 Typical High $16.22 | Professional | 53 · Discontinued | $6.76 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $45.71 Typical High $60.26 | Professional | 54 · Surgery only | $25.12 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $9.12 Typical High $12.02 | Professional | 55 · Aftercare only | $5.01 | $9.12 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $6.17 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.39 | $6.17 | $8.13 |
Where New Jersey sits
The same service costs 3.2 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
$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.