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 $61.66 Median $4,466.84 Typical High $10,964.78 | Facility | None | $61.66 | $4,466.84 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $141.25 | Professional | None | $47.86 | $81.28 | $141.25 |
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 $33.88 Median $66.07 Typical High $204.17 | Professional | None | $33.88 | $66.07 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | None | $85.11 | $128.82 | $128.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $933.25 | Facility | None | $446.68 | $676.08 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $47.86 Median $91.20 Typical High $281.84 | Professional | None | $47.86 | $91.20 | $281.84 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $28.18 Median $56.23 Typical High $141.25 | Professional | None | $28.18 | $56.23 | $141.25 |
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 $28.84 Median $33.88 Typical High $70.79 | Professional | 52 · Reduced service | $28.84 | $33.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.80 Typical High $28.18 | Professional | 53 · Discontinued | $11.48 | $13.80 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $51.29 Typical High $104.71 | Professional | 54 · Surgery only | $43.65 | $51.29 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.23 Typical High $20.89 | Professional | 55 · Aftercare only | $8.71 | $10.23 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.92 Typical High $14.13 | Professional | 56 · Pre-op care only | $5.75 | $6.92 | $14.13 |
Where New Jersey sits
The same service costs 3.2 times more in Wisconsin 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· 35th of 51
$89.13
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.