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 $295.12 Median $4,786.30 Typical High $10,232.93 | Facility | None | $295.12 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $676.08 | Professional | None | $263.03 | $416.87 | $676.08 |
AmeriHealth Setting Facility Modifier None Typical Low $831.76 Median $5,128.61 Typical High $12,589.25 | Facility | None | $831.76 | $5,128.61 | $12,589.25 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,584.89 | $2,818.38 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $794.33 | Professional | None | $245.47 | $389.05 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $645.65 | Professional | None | $446.68 | $645.65 | $645.65 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $6,760.83 Typical High $18,620.87 | Facility | None | $3,801.89 | $6,760.83 | $18,620.87 |
Horizon BCBS Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $1,096.48 | Professional | None | $269.15 | $436.52 | $1,096.48 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $4,168.69 | Facility | None | $537.03 | $1,548.82 | $4,168.69 |
United Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $691.83 | Professional | None | $269.15 | $426.58 | $691.83 |
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 $144.54 Median $208.93 Typical High $218.78 | Professional | 52 · Reduced service | $144.54 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $58.88 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $309.03 Typical High $323.59 | Professional | 54 · Surgery only | $218.78 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $43.65 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $29.51 | $41.69 | $43.65 |
Where New Jersey sits
The same service costs 3.9 times more in Alaska than in New York. 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· 35th of 51
$437
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.