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 $87.10 Median $4,365.16 Typical High $10,471.29 | Facility | None | $87.10 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $151.36 | Professional | None | $87.10 | $95.50 | $151.36 |
AmeriHealth Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $407.38 | Professional | None | $85.11 | $147.91 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $1,659.59 | Facility | None | $56.23 | $100.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $204.17 | Professional | None | $58.88 | $107.15 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $123.03 | Professional | None | $89.13 | $123.03 | $123.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $95.50 Median $162.18 Typical High $2,630.27 | Facility | None | $95.50 | $162.18 | $2,630.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $40.74 Median $85.11 Typical High $208.93 | Professional | None | $40.74 | $85.11 | $208.93 |
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 $22.91 Median $45.71 Typical High $114.82 | Professional | None | $22.91 | $45.71 | $114.82 |
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 $43.65 Median $47.86 Typical High $75.86 | Professional | 52 · Reduced service | $43.65 | $47.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.05 Typical High $30.20 | Professional | 53 · Discontinued | $17.38 | $19.05 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $72.44 Typical High $114.82 | Professional | 54 · Surgery only | $64.57 | $72.44 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.45 Typical High $22.91 | Professional | 55 · Aftercare only | $12.88 | $14.45 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $15.14 |
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· 33rd of 51
$85.11
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.