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 $575.44 Median $4,570.88 Typical High $10,471.29 | Facility | None | $575.44 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | None | $575.44 | $575.44 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $6,025.60 Typical High $19,498.45 | Facility | None | $2,137.96 | $6,025.60 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,202.26 | Professional | None | $575.44 | $933.25 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $831.76 Typical High $831.76 | Professional | None | $323.59 | $831.76 | $831.76 |
Horizon BCBS Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $912.01 | Professional | None | $512.86 | $549.54 | $912.01 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,715.35 Typical High $8,912.51 | Facility | None | $1,318.26 | $3,715.35 | $8,912.51 |
United Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $707.95 | Professional | None | $281.84 | $346.74 | $707.95 |
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 $281.84 Median $281.84 Typical High $288.40 | Professional | 52 · Reduced service | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $436.52 | Professional | 54 · Surgery only | $426.58 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Where New Jersey sits
The same service costs 10.5 times more in Alaska 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· 33rd of 51
$575
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.