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 $70.79 Median $2,754.23 Typical High $9,772.37 | Facility | None | $70.79 | $2,754.23 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $147.91 | Professional | None | $64.57 | $112.20 | $147.91 |
AmeriHealth Setting Facility Modifier None Typical Low $3,981.07 Median $6,918.31 Typical High $10,964.78 | Facility | None | $3,981.07 | $6,918.31 | $10,964.78 |
AmeriHealth Setting Professional Modifier None Typical Low $52.48 Median $213.80 Typical High $371.54 | Professional | None | $52.48 | $213.80 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $194.98 Typical High $1,659.59 | Facility | None | $109.65 | $194.98 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $199.53 | Professional | None | $69.18 | $123.03 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | None | $147.91 | $199.53 | $199.53 |
Horizon BCBS Setting Facility Modifier None Typical Low $151.36 Median $269.15 Typical High $1,148.15 | Facility | None | $151.36 | $269.15 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $46.77 Median $114.82 Typical High $208.93 | Professional | None | $46.77 | $114.82 | $208.93 |
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 |
United Setting Professional Modifier None Typical Low $28.18 Median $69.18 Typical High $154.88 | Professional | None | $28.18 | $69.18 | $154.88 |
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 $31.62 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $31.62 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.50 Typical High $25.70 | Professional | 53 · Discontinued | $12.88 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $72.44 Typical High $97.72 | Professional | 54 · Surgery only | $47.86 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $9.55 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.46 | $9.77 | $12.88 |
Where New Jersey sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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
$89.13
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.