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 $107.15 Median $3,388.44 Typical High $10,000.00 | Facility | None | $107.15 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $229.09 | Professional | None | $93.33 | $134.90 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $169.82 Typical High $1,659.59 | Facility | None | $95.50 | $169.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $331.13 | Professional | None | $89.13 | $151.36 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $245.47 | Professional | None | $165.96 | $245.47 | $245.47 |
Horizon BCBS Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $1,148.15 | Facility | None | $147.91 | $263.03 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $380.19 | Professional | None | $97.72 | $165.96 | $380.19 |
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 $97.72 Median $151.36 Typical High $263.03 | Professional | None | $97.72 | $151.36 | $263.03 |
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 $51.29 Median $63.10 Typical High $70.79 | Professional | 52 · Reduced service | $51.29 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $28.18 | Professional | 53 · Discontinued | $20.42 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $95.50 Typical High $104.71 | Professional | 54 · Surgery only | $77.62 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.05 Typical High $20.89 | Professional | 55 · Aftercare only | $15.49 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $14.13 |
Where New Jersey sits
The same service costs 3.2 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· 33rd of 51
$155
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.