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 $5,888.44 Typical High $10,964.78 | Facility | None | $4,365.16 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $8,317.64 | Professional | None | $436.52 | $489.78 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,023.29 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $1,071.52 | Professional | None | $575.44 | $602.56 | $1,071.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $158.49 Median $288.40 Typical High $812.83 | Facility | None | $158.49 | $288.40 | $812.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $1,348.96 | Professional | None | $489.78 | $562.34 | $1,348.96 |
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 |
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 $218.78 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $87.10 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $426.58 | Professional | 54 · Surgery only | $323.59 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $64.57 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $43.65 | $48.98 | $57.54 |
Where New Jersey sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 24th of 51
$631
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.