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 $67.61 Median $3,311.31 Typical High $10,000.00 | Facility | None | $67.61 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $147.91 | Professional | None | $61.66 | $89.13 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $125.89 Typical High $1,659.59 | Facility | None | $70.79 | $125.89 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $218.78 | Professional | None | $57.54 | $100.00 | $218.78 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $169.82 | Professional | None | $114.82 | $169.82 | $169.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $107.15 Median $190.55 Typical High $3,467.37 | Facility | None | $107.15 | $190.55 | $3,467.37 |
Horizon BCBS Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $245.47 | Professional | None | $63.10 | $109.65 | $245.47 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $173.78 | Professional | None | $63.10 | $102.33 | $173.78 |
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 $32.36 Median $41.69 Typical High $45.71 | Professional | 52 · Reduced service | $32.36 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $18.20 | Professional | 53 · Discontinued | $12.88 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $63.10 Typical High $69.18 | Professional | 54 · Surgery only | $48.98 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $12.59 Typical High $13.80 | Professional | 55 · Aftercare only | $9.77 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.46 | $8.32 | $9.12 |
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
$107
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.