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 $64.57 Median $3,388.44 Typical High $10,000.00 | Facility | None | $64.57 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $117.49 | Professional | None | $64.57 | $91.20 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $87.10 Typical High $1,659.59 | Facility | None | $48.98 | $87.10 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $158.49 | Professional | None | $67.61 | $97.72 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $125.89 | Professional | None | $93.33 | $125.89 | $125.89 |
Horizon BCBS Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $1,148.15 | Facility | None | $66.07 | $123.03 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $50.12 Median $81.28 Typical High $177.83 | Professional | None | $50.12 | $81.28 | $177.83 |
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 $26.92 Median $48.98 Typical High $107.15 | Professional | None | $26.92 | $48.98 | $107.15 |
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 $32.36 Median $37.15 Typical High $52.48 | Professional | 52 · Reduced service | $32.36 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $14.79 Typical High $21.38 | Professional | 53 · Discontinued | $12.88 | $14.79 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $56.23 Typical High $79.43 | Professional | 54 · Surgery only | $47.86 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.22 Typical High $15.85 | Professional | 55 · Aftercare only | $9.77 | $11.22 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.41 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.46 | $7.41 | $10.72 |
Where New Jersey sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 38th of 51
$77.62
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.