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 $154.88 Median $4,570.88 Typical High $10,471.29 | Facility | None | $154.88 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $218.78 | Professional | None | $154.88 | $190.55 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $316.23 Typical High $724.44 | Facility | None | $181.97 | $316.23 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $416.87 | Professional | None | $194.98 | $218.78 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $263.03 | Professional | None | $194.98 | $251.19 | $263.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $281.84 Median $501.19 Typical High $1,148.15 | Facility | None | $281.84 | $501.19 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $478.63 | Professional | None | $173.78 | $199.53 | $478.63 |
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 $134.90 Median $173.78 Typical High $354.81 | Professional | None | $134.90 | $173.78 | $354.81 |
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 $77.62 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $30.90 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $114.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $23.44 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.49 | $19.05 | $19.05 |
Where New Jersey sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 36th of 51
$219
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.