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 $134.90 Median $3,467.37 Typical High $10,000.00 | Facility | None | $134.90 | $3,467.37 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $194.98 | Professional | None | $134.90 | $177.83 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $199.53 Typical High $389.05 | Facility | None | $109.65 | $199.53 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $331.13 | Professional | None | $165.96 | $218.78 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | None | $223.87 | $309.03 | $309.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $2,884.03 | Facility | None | $169.82 | $302.00 | $2,884.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $363.08 | Professional | None | $125.89 | $204.17 | $363.08 |
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 $67.61 Median $117.49 Typical High $257.04 | Professional | None | $67.61 | $117.49 | $257.04 |
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 $67.61 Median $81.28 Typical High $95.50 | Professional | 52 · Reduced service | $67.61 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $27.54 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $123.03 Typical High $144.54 | Professional | 54 · Surgery only | $102.33 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $24.55 Typical High $28.84 | Professional | 55 · Aftercare only | $20.42 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.22 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.80 | $16.22 | $19.50 |
Where New Jersey sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 38th of 51
$178
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.