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 $13.18 Median $4,466.84 Typical High $10,471.29 | Facility | None | $13.18 | $4,466.84 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.49 Typical High $30.20 | Professional | None | $13.18 | $13.49 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
AmeriHealth Setting Facility Modifier None Typical Low $2,754.23 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,786.30 | $7,585.78 |
AmeriHealth Setting Professional Modifier None Typical Low $14.45 Median $21.88 Typical High $33.88 | Professional | None | $14.45 | $21.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $389.05 Typical High $2,089.30 | Facility | None | $66.07 | $389.05 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $16.22 Typical High $34.67 | Professional | None | $11.22 | $16.22 | $34.67 |
Emblem Health Setting Professional Modifier None Typical Low $19.05 Median $28.84 Typical High $28.84 | Professional | None | $19.05 | $28.84 | $28.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $275.42 | Facility | None | $131.83 | $199.53 | $275.42 |
Horizon BCBS Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $41.69 | Professional | None | $14.13 | $16.98 | $41.69 |
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 $8.71 Median $12.88 Typical High $31.62 | Professional | None | $8.71 | $12.88 | $31.62 |
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 $6.31 Median $6.76 Typical High $7.24 | Professional | 52 · Reduced service | $6.31 | $6.76 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.69 Typical High $2.88 | Professional | 53 · Discontinued | $2.51 | $2.69 | $2.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.33 Median $10.00 Typical High $11.22 | Professional | 54 · Surgery only | $9.33 | $10.00 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $2.00 Typical High $2.14 | Professional | 55 · Aftercare only | $1.86 | $2.00 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.35 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.26 | $1.35 | $1.45 |
Where New Jersey sits
The same service costs 7.4 times more in Kansas 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· 43rd of 51
$18.62
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.