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 $120.23 Median $3,311.31 Typical High $10,000.00 | Facility | None | $120.23 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $218.78 | Professional | None | $120.23 | $162.18 | $218.78 |
AmeriHealth Setting Facility Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $7,943.28 | Facility | None | $1,659.59 | $2,884.03 | $7,943.28 |
AmeriHealth Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $407.38 | Professional | None | $162.18 | $162.18 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $389.05 | Facility | None | $125.89 | $223.87 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $302.00 | Professional | None | $151.36 | $199.53 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | None | $229.09 | $309.03 | $309.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $177.83 Median $331.13 Typical High $2,630.27 | Facility | None | $177.83 | $331.13 | $2,630.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $331.13 | Professional | None | $109.65 | $199.53 | $331.13 |
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 $60.26 Median $114.82 Typical High $245.47 | Professional | None | $60.26 | $114.82 | $245.47 |
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 $60.26 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $60.26 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.84 Typical High $35.48 | Professional | 53 · Discontinued | $23.99 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $109.65 Typical High $131.83 | Professional | 54 · Surgery only | $89.13 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $21.88 Typical High $26.92 | Professional | 55 · Aftercare only | $17.78 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.45 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.02 | $14.45 | $17.78 |
Where New Jersey sits
The same service costs 3.3 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· 42nd of 51
$162
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.