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 $83.18 Median $3,388.44 Typical High $10,000.00 | Facility | None | $83.18 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $134.90 | Professional | None | $83.18 | $114.82 | $134.90 |
AmeriHealth Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $199.53 | Professional | None | $144.54 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,023.29 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $204.17 | Professional | None | $104.71 | $134.90 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | None | $154.88 | $208.93 | $208.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $223.87 | Professional | None | $75.86 | $134.90 | $223.87 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,412.54 Typical High $3,890.45 | Facility | None | $309.03 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $40.74 Median $77.62 Typical High $173.78 | Professional | None | $40.74 | $77.62 | $173.78 |
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 $41.69 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $41.69 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $16.60 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $63.10 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $12.59 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.32 | $10.23 | $12.30 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 37th of 51
$115
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.