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 $134.90 Median $3,467.37 Typical High $10,000.00 | Facility | None | $134.90 | $3,467.37 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $245.47 | Professional | None | $114.82 | $190.55 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,995.26 | Facility | None | $616.60 | $1,202.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $426.58 | Professional | None | $107.15 | $204.17 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | None | $218.78 | $331.13 | $331.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,137.96 | $6,760.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $537.03 | Professional | None | $117.49 | $234.42 | $537.03 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $380.19 | Professional | None | $77.62 | $154.88 | $380.19 |
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 $57.54 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $57.54 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $22.91 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $87.10 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.48 | $18.20 | $21.38 |
Where New Jersey sits
The same service costs 4.0 times more in Alaska 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· 40th of 51
$209
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.