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 $95.50 Median $3,311.31 Typical High $10,000.00 | Facility | None | $95.50 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $151.36 | Professional | None | $95.50 | $128.82 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $181.97 Typical High $1,659.59 | Facility | None | $102.33 | $181.97 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $208.93 | Professional | None | $74.13 | $134.90 | $208.93 |
Emblem Health Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $199.53 | Professional | None | $144.54 | $199.53 | $199.53 |
Horizon BCBS Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $2,884.03 | Facility | None | $134.90 | $245.47 | $2,884.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $52.48 Median $131.83 Typical High $223.87 | Professional | None | $52.48 | $131.83 | $223.87 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $29.51 Median $72.44 Typical High $147.91 | Professional | None | $29.51 | $72.44 | $147.91 |
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 $46.77 Median $53.70 Typical High $69.18 | Professional | 52 · Reduced service | $46.77 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $21.38 Typical High $27.54 | Professional | 53 · Discontinued | $19.05 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $79.43 Typical High $102.33 | Professional | 54 · Surgery only | $70.79 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.85 Typical High $20.42 | Professional | 55 · Aftercare only | $14.13 | $15.85 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.72 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.55 | $10.72 | $13.80 |
Where New Jersey sits
The same service costs 3.2 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
$95.50
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.