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 $128.82 Median $3,388.44 Typical High $10,000.00 | Facility | None | $128.82 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $288.40 | Professional | None | $120.23 | $158.49 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $204.17 Typical High $1,659.59 | Facility | None | $114.82 | $204.17 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $371.54 | Professional | None | $107.15 | $177.83 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $295.12 | Professional | None | $204.17 | $295.12 | $295.12 |
Horizon BCBS Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $3,467.37 | Facility | None | $169.82 | $309.03 | $3,467.37 |
Horizon BCBS Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $446.68 | Professional | None | $117.49 | $194.98 | $446.68 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,584.89 Typical High $3,981.07 | Facility | None | $537.03 | $1,584.89 | $3,981.07 |
United Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $309.03 | Professional | None | $117.49 | $186.21 | $309.03 |
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 $60.26 Median $77.62 Typical High $81.28 | Professional | 52 · Reduced service | $60.26 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $31.62 Typical High $32.36 | Professional | 53 · Discontinued | $24.55 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $117.49 Typical High $120.23 | Professional | 54 · Surgery only | $91.20 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.44 Typical High $23.99 | Professional | 55 · Aftercare only | $18.20 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $16.22 |
Where New Jersey sits
The same service costs 3.7 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· 37th of 51
$186
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.