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 $4,466.84 Median $10,232.93 Typical High $13,489.63 | Facility | None | $4,466.84 | $10,232.93 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | None | $562.34 | $602.56 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $13,489.63 Typical High $23,988.33 | Facility | None | $1,995.26 | $13,489.63 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,445.44 | Professional | None | $416.87 | $691.83 | $1,445.44 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $891.25 | Professional | None | $602.56 | $891.25 | $891.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $19,054.61 Typical High $52,480.75 | Facility | None | $10,471.29 | $19,054.61 | $52,480.75 |
Horizon BCBS Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,698.24 | Professional | None | $602.56 | $691.83 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,786.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $1,318.26 | Professional | None | $316.23 | $489.78 | $1,318.26 |
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 $281.84 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $281.84 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $426.58 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $60.26 |
Where New Jersey sits
The same service costs 11.7 times more in Oklahoma 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· 38th of 51
$794
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.