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 $60.26 Median $4,365.16 Typical High $10,964.78 | Facility | None | $60.26 | $4,365.16 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $104.71 | Professional | None | $58.88 | $79.43 | $104.71 |
AmeriHealth Setting Facility Modifier None Typical Low $158.49 Median $331.13 Typical High $7,079.46 | Facility | None | $158.49 | $331.13 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $109.65 Typical High $1,659.59 | Facility | None | $61.66 | $109.65 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $186.21 | Professional | None | $50.12 | $87.10 | $186.21 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | None | $102.33 | $151.36 | $151.36 |
Horizon BCBS Setting Facility Modifier None Typical Low $89.13 Median $162.18 Typical High $758.58 | Facility | None | $89.13 | $162.18 | $758.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $56.23 Median $102.33 Typical High $234.42 | Professional | None | $56.23 | $102.33 | $234.42 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,348.96 Typical High $3,890.45 | Facility | None | $309.03 | $1,348.96 | $3,890.45 |
United Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $158.49 | Professional | None | $54.95 | $93.33 | $158.49 |
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 $28.84 Median $37.15 Typical High $44.67 | Professional | 52 · Reduced service | $28.84 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $11.75 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $54.95 Typical High $67.61 | Professional | 54 · Surgery only | $43.65 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.96 Typical High $13.49 | Professional | 55 · Aftercare only | $8.71 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.89 | $7.41 | $8.91 |
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· 37th of 51
$93.33
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.