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 $457.09 Median $501.19 Typical High $891.25 | Professional | None | $457.09 | $501.19 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,071.52 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,122.02 | Professional | None | $524.81 | $602.56 | $1,122.02 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $707.95 | Professional | None | $489.78 | $660.69 | $707.95 |
Horizon BCBS Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $1,380.38 | Professional | None | $467.74 | $537.03 | $1,380.38 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $954.99 | Professional | None | $354.81 | $467.74 | $954.99 |
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 $229.09 Median $251.19 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $56.23 |
Where New Jersey sits
The same service costs 3.4 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· 46th of 51
$537
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.