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 $74.13 Median $3,548.13 Typical High $10,232.93 | Facility | None | $74.13 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $123.03 | Professional | None | $74.13 | $91.20 | $123.03 |
AmeriHealth Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $109.65 Typical High $1,659.59 | Facility | None | $61.66 | $109.65 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $104.71 Typical High $177.83 | Professional | None | $61.66 | $104.71 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $131.83 | Professional | None | $95.50 | $131.83 | $131.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $93.33 Median $165.96 Typical High $1,258.93 | Facility | None | $93.33 | $165.96 | $1,258.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $173.78 | Professional | None | $40.74 | $79.43 | $173.78 |
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 $22.91 Median $47.86 Typical High $109.65 | Professional | None | $22.91 | $47.86 | $109.65 |
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 $37.15 Median $45.71 Typical High $61.66 | Professional | 52 · Reduced service | $37.15 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.20 Typical High $24.55 | Professional | 53 · Discontinued | $14.79 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $67.61 Typical High $93.33 | Professional | 54 · Surgery only | $56.23 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $18.62 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.12 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.41 | $9.12 | $12.30 |
Where New Jersey sits
The same service costs 3.0 times more in Alaska than in Virginia. 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· 48th of 51
$79.43
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.