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 $109.65 Median $4,786.30 Typical High $10,471.29 | Facility | None | $109.65 | $4,786.30 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | None | $97.72 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $776.25 Typical High $1,659.59 | Facility | None | $426.58 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $478.63 | Professional | None | $104.71 | $173.78 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $177.83 | Professional | None | $123.03 | $169.82 | $177.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $2,630.27 | Facility | None | $588.84 | $1,122.02 | $2,630.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $371.54 | Professional | None | $112.20 | $120.23 | $371.54 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $524.81 | Professional | None | $95.50 | $128.82 | $524.81 |
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 $48.98 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $48.98 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $19.50 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 54 · Surgery only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $14.79 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.77 | $11.22 | $11.22 |
Where New Jersey sits
The same service costs 4.4 times more in Alaska 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· 30th of 51
$162
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.