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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | None | $154.88 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,089.30 Typical High $3,019.95 | Facility | None | $489.78 | $2,089.30 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $371.54 | Professional | None | $177.83 | $288.40 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | None | $181.97 | $245.47 | $245.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $295.12 | Professional | None | $190.55 | $204.17 | $295.12 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,890.45 | Facility | None | $309.03 | $1,380.38 | $3,890.45 |
United Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $275.42 | Professional | None | $83.18 | $114.82 | $275.42 |
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 $77.62 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $31.62 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $117.49 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $23.44 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.49 | $19.05 | $19.05 |
Where New Jersey sits
The same service costs 4.5 times more in Alaska than in New York. 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
$191
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.