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 $47.86 Median $4,365.16 Typical High $10,964.78 | Facility | None | $47.86 | $4,365.16 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $91.20 Typical High $120.23 | Professional | None | $42.66 | $91.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $1,659.59 | Facility | None | $75.86 | $134.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $70.79 Typical High $208.93 | Professional | None | $30.90 | $70.79 | $208.93 |
Emblem Health Setting Professional Modifier None Typical Low $12.30 Median $83.18 Typical High $151.36 | Professional | None | $12.30 | $83.18 | $151.36 |
Horizon BCBS Setting Facility Modifier None Typical Low $123.03 Median $218.78 Typical High $891.25 | Facility | None | $123.03 | $218.78 | $891.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $44.67 Median $114.82 Typical High $223.87 | Professional | None | $44.67 | $114.82 | $223.87 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,348.96 Typical High $3,890.45 | Facility | None | $309.03 | $1,348.96 | $3,890.45 |
United Setting Professional Modifier None Typical Low $23.99 Median $61.66 Typical High $169.82 | Professional | None | $23.99 | $61.66 | $169.82 |
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 $21.88 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $21.88 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $8.91 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $63.10 Typical High $74.13 | Professional | 54 · Surgery only | $33.11 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $6.61 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $8.51 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.47 | $8.51 | $9.77 |
Where New Jersey sits
The same service costs 3.3 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· 27th of 51
$97.72
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.