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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $245.47 | Professional | None | $173.78 | $208.93 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $269.15 Typical High $389.05 | Facility | None | $173.78 | $269.15 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $478.63 | Professional | None | $218.78 | $251.19 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $295.12 | Professional | None | $204.17 | $281.84 | $295.12 |
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 $194.98 Median $223.87 Typical High $549.54 | Professional | None | $194.98 | $223.87 | $549.54 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $398.11 | Professional | None | $151.36 | $194.98 | $398.11 |
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 $87.10 Median $104.71 Typical High $107.15 | Professional | 52 · Reduced service | $87.10 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $42.66 | Professional | 53 · Discontinued | $34.67 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $158.49 Typical High $162.18 | Professional | 54 · Surgery only | $131.83 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $26.30 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.89 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.38 | $20.89 | $21.38 |
Where New Jersey sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 32nd of 51
$245
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.