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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $269.15 | Professional | None | $213.80 | $245.47 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $1,659.59 | Facility | None | $199.53 | $354.81 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $602.56 | Professional | None | $186.21 | $257.04 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | None | $275.42 | $407.38 | $407.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $269.15 Median $501.19 Typical High $1,148.15 | Facility | None | $269.15 | $501.19 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $724.44 | Professional | None | $204.17 | $288.40 | $724.44 |
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 $199.53 Median $288.40 Typical High $512.86 | Professional | None | $199.53 | $288.40 | $512.86 |
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 $107.15 Median $123.03 Typical High $131.83 | Professional | 52 · Reduced service | $107.15 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $42.66 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $158.49 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $39.81 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $24.55 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.38 | $24.55 | $26.92 |
Where New Jersey sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$288
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.