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 $51.29 Median $6,918.31 Typical High $12,882.50 | Facility | None | $51.29 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $51.29 Typical High $81.28 | Professional | None | $26.92 | $51.29 | $81.28 |
AmeriHealth Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $34.67 | Professional | None | $18.62 | $18.62 | $34.67 |
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 $15.14 Median $17.78 Typical High $69.18 | Professional | None | $15.14 | $17.78 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $30.20 Typical High $30.20 | Professional | None | $22.39 | $30.20 | $30.20 |
Horizon BCBS Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $616.60 | Facility | None | $295.12 | $446.68 | $616.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $67.61 | Professional | None | $27.54 | $30.20 | $67.61 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,801.89 | Facility | None | $309.03 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $14.45 Median $19.05 Typical High $51.29 | Professional | None | $14.45 | $19.05 | $51.29 |
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 $24.55 Median $24.55 Typical High $26.30 | Professional | 52 · Reduced service | $24.55 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.47 | Professional | 53 · Discontinued | $9.77 | $9.77 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $37.15 Typical High $38.90 | Professional | 54 · Surgery only | $36.31 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.41 Typical High $7.76 | Professional | 55 · Aftercare only | $7.24 | $7.41 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $5.25 |
Where New Jersey sits
The same service costs 4.3 times more in Wyoming 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· 39th of 51
$32.36
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.