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 $46.77 Median $79.43 Typical High $10,471.29 | Facility | None | $46.77 | $79.43 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $72.44 Typical High $107.15 | Professional | None | $42.66 | $72.44 | $107.15 |
AmeriHealth Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $47.86 | Professional | None | $22.91 | $35.48 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $74.13 Typical High $354.81 | Facility | None | $41.69 | $74.13 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $158.49 | Professional | None | $39.81 | $72.44 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $114.82 | Professional | None | $77.62 | $114.82 | $114.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $70.79 Median $131.83 Typical High $758.58 | Facility | None | $70.79 | $131.83 | $758.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $199.53 | Professional | None | $44.67 | $77.62 | $199.53 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $125.89 | Professional | None | $44.67 | $70.79 | $125.89 |
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 $23.44 Median $30.20 Typical High $39.81 | Professional | 52 · Reduced service | $23.44 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.02 Typical High $15.85 | Professional | 53 · Discontinued | $9.33 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $44.67 Typical High $58.88 | Professional | 54 · Surgery only | $35.48 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.91 Typical High $12.02 | Professional | 55 · Aftercare only | $7.08 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.03 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.68 | $6.03 | $7.94 |
Where New Jersey sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 34th of 51
$77.62
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.