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 $45.71 Median $4,897.79 Typical High $10,964.78 | Facility | None | $45.71 | $4,897.79 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $61.66 | Professional | None | $26.92 | $38.90 | $61.66 |
AmeriHealth Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $72.44 | Professional | None | $34.67 | $43.65 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $3,019.95 | Facility | None | $954.99 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $81.28 | Professional | None | $25.12 | $38.02 | $81.28 |
Emblem Health Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $63.10 | Professional | None | $44.67 | $63.10 | $63.10 |
Horizon BCBS Setting Professional Modifier None Typical Low $28.18 Median $43.65 Typical High $104.71 | Professional | None | $28.18 | $43.65 | $104.71 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,890.45 | Facility | None | $309.03 | $1,380.38 | $3,890.45 |
United Setting Professional Modifier None Typical Low $27.54 Median $42.66 Typical High $70.79 | Professional | None | $27.54 | $42.66 | $70.79 |
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 $14.79 Median $17.38 Typical High $19.50 | Professional | 52 · Reduced service | $14.79 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.92 Typical High $7.76 | Professional | 53 · Discontinued | $5.89 | $6.92 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $25.70 Typical High $28.84 | Professional | 54 · Surgery only | $22.39 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.25 Typical High $5.75 | Professional | 55 · Aftercare only | $4.47 | $5.25 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.47 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.95 | $3.47 | $3.89 |
Where New Jersey sits
The same service costs 3.3 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· 43rd of 51
$40.74
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.