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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $537.03 | Professional | None | $446.68 | $457.09 | $537.03 |
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 $562.34 Median $616.60 Typical High $1,096.48 | Professional | None | $562.34 | $616.60 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $758.58 | Professional | None | $524.81 | $724.44 | $758.58 |
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 $512.86 Median $588.84 Typical High $1,412.54 | Professional | None | $512.86 | $588.84 | $1,412.54 |
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 $389.05 Median $501.19 Typical High $1,023.29 | Professional | None | $389.05 | $501.19 | $1,023.29 |
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 $223.87 Median $229.09 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $53.70 |
Where New Jersey sits
The same service costs 3.2 times more in Wisconsin than in Arkansas. 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· 30th of 51
$589
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.