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 $52.48 Median $2,754.23 Typical High $9,772.37 | Facility | None | $52.48 | $2,754.23 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $79.43 Typical High $144.54 | Professional | None | $47.86 | $79.43 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
AmeriHealth Setting Facility Modifier None Typical Low $588.84 Median $7,943.28 Typical High $11,748.98 | Facility | None | $588.84 | $7,943.28 | $11,748.98 |
AmeriHealth Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $147.91 | Professional | None | $48.98 | $66.07 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $104.71 Typical High $194.98 | Professional | None | $43.65 | $104.71 | $194.98 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $173.78 | Professional | None | $112.20 | $173.78 | $173.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $48.98 Median $104.71 Typical High $218.78 | Professional | None | $48.98 | $104.71 | $218.78 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,412.54 Typical High $3,890.45 | Facility | None | $309.03 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $169.82 | Professional | None | $48.98 | $89.13 | $169.82 |
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 $26.30 Median $33.88 Typical High $45.71 | Professional | 52 · Reduced service | $26.30 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.49 Typical High $18.20 | Professional | 53 · Discontinued | $10.47 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $50.12 Typical High $67.61 | Professional | 54 · Surgery only | $38.90 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.00 Typical High $13.49 | Professional | 55 · Aftercare only | $7.76 | $10.00 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.25 | $6.76 | $9.12 |
Where New Jersey sits
The same service costs 3.2 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· 30th of 51
$97.72
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.