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 $97.72 Median $109.65 Typical High $10,471.29 | Facility | None | $97.72 | $109.65 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $173.78 | Professional | None | $97.72 | $109.65 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $162.18 | Professional | None | $79.43 | $93.33 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $186.21 | Professional | None | $141.25 | $186.21 | $186.21 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,513.56 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $199.53 | Professional | None | $97.72 | $131.83 | $199.53 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $128.82 | Professional | None | $69.18 | $95.50 | $128.82 |
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 $48.98 Median $53.70 Typical High $54.95 | Professional | 52 · Reduced service | $48.98 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.88 Typical High $22.39 | Professional | 53 · Discontinued | $19.50 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $81.28 Typical High $83.18 | Professional | 54 · Surgery only | $72.44 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $16.60 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $10.96 |
Where New Jersey sits
The same service costs 4.5 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· 49th of 51
$105
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.