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 $107.15 Median $138.04 Typical High $776.25 | Facility | None | $107.15 | $138.04 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $190.55 | Professional | None | $89.13 | $107.15 | $190.55 |
AmeriHealth Setting Facility Modifier None Typical Low $8,709.64 Median $12,882.50 Typical High $20,417.38 | Facility | None | $8,709.64 | $12,882.50 | $20,417.38 |
AmeriHealth Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $194.98 | Professional | None | $89.13 | $104.71 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $3,890.45 | Facility | None | $1,023.29 | $2,290.87 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $251.19 | Professional | None | $112.20 | $128.82 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $154.88 | Professional | None | $107.15 | $147.91 | $154.88 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $12,302.69 | Facility | None | $2,691.53 | $4,897.79 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $295.12 | Professional | None | $100.00 | $114.82 | $295.12 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,818.38 | $6,760.83 |
United Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $204.17 | Professional | None | $79.43 | $102.33 | $204.17 |
4 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 $48.98 Median $53.70 Typical High $69.18 | Professional | 52 · Reduced service | $48.98 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.38 Typical High $27.54 | Professional | 53 · Discontinued | $19.50 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.85 Typical High $20.89 | Professional | 55 · Aftercare only | $14.45 | $15.85 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.72 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.77 | $10.72 | $13.80 |
Where New Jersey sits
The same service costs 7.9 times more in Kansas 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· 37th of 51
$138
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.