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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $218.78 | Professional | None | $169.82 | $186.21 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,513.56 Typical High $2,511.89 | Facility | None | $501.19 | $1,513.56 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $398.11 | Professional | None | $177.83 | $213.80 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $263.03 | Professional | None | $181.97 | $239.88 | $263.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $446.68 | Professional | None | $177.83 | $208.93 | $446.68 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $478.63 | Professional | None | $144.54 | $218.78 | $478.63 |
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 $85.11 Median $93.33 Typical High $100.00 | Professional | 52 · Reduced service | $85.11 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $37.15 Typical High $39.81 | Professional | 53 · Discontinued | $33.88 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $141.25 Typical High $147.91 | Professional | 54 · Surgery only | $128.82 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $25.70 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.62 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.98 | $18.62 | $19.95 |
Where New Jersey sits
The same service costs 3.8 times more in Alaska than in New York. 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· 39th of 51
$234
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.