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 $128.82 Median $128.82 Typical High $162.18 | Professional | None | $128.82 | $128.82 | $162.18 |
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 $125.89 Median $199.53 Typical High $457.09 | Professional | None | $125.89 | $199.53 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $194.98 | Professional | None | $134.90 | $181.97 | $194.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $416.87 | Professional | None | $131.83 | $141.25 | $416.87 |
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 $107.15 Median $141.25 Typical High $630.96 | Professional | None | $107.15 | $141.25 | $630.96 |
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 $64.57 Median $64.57 Typical High $70.79 | Professional | 52 · Reduced service | $64.57 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 53 · Discontinued | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 54 · Surgery only | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $20.89 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $14.13 |
Where New Jersey sits
The same service costs 3.9 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· 39th 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.