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 $32.36 Median $39.81 Typical High $10,471.29 | Facility | None | $32.36 | $39.81 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $75.86 | Professional | None | $32.36 | $39.81 | $75.86 |
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 $26.92 Median $34.67 Typical High $57.54 | Professional | None | $26.92 | $34.67 | $57.54 |
Emblem Health Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $67.61 | Professional | None | $50.12 | $67.61 | $67.61 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $2,089.30 | Facility | None | $1,000.00 | $1,659.59 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $70.79 | Professional | None | $33.88 | $47.86 | $70.79 |
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 $23.44 Median $33.88 Typical High $43.65 | Professional | None | $23.44 | $33.88 | $43.65 |
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 $16.22 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $16.22 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $6.46 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 54 · Surgery only | $24.55 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $4.90 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.24 | $3.98 | $3.98 |
Where New Jersey sits
The same service costs 3.8 times more in Alaska than in Utah. 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· 46th of 51
$38.90
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.