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 $389.05 Median $6,309.57 Typical High $10,471.29 | Facility | None | $389.05 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $575.44 | Professional | None | $302.00 | $389.05 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,019.95 Typical High $5,128.61 | Facility | None | $1,174.90 | $3,019.95 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $831.76 | Professional | None | $275.42 | $371.54 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $436.52 | Professional | None | $316.23 | $436.52 | $436.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,760.83 Typical High $20,417.38 | Facility | None | $3,548.13 | $6,760.83 | $20,417.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $1,000.00 | Professional | None | $302.00 | $354.81 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $724.44 | Professional | None | $281.84 | $363.08 | $724.44 |
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 $154.88 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $154.88 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $61.66 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $234.42 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $57.54 Typical High $60.26 | Professional | 55 · Aftercare only | $46.77 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.90 | $38.90 | $39.81 |
Where New Jersey sits
The same service costs 10.0 times more in Oklahoma 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· 38th of 51
$457
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.