How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | None (both parts) | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $40.74 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.60 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.80 Typical High $14.13 | Professional | 55 · Aftercare only | $12.30 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.13 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,202.26 Typical High $1,445.44 | Facility | None | $562.34 | $1,202.26 | $1,445.44 |
Cigna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $70.79 Typical High $162.18 | Professional | None (both parts) | $66.07 | $70.79 | $162.18 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | None (both parts) | $104.71 | $104.71 | $117.49 |
Horizon BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,737.80 | Facility | None | $831.76 | $1,380.38 | $1,737.80 |
Horizon BCBS Setting Professional Modifier None (both parts) Typical Low $102.33 Median $104.71 Typical High $181.97 | Professional | None (both parts) | $102.33 | $104.71 | $181.97 |
United Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,548.82 | Facility | None | $724.44 | $724.44 | $1,548.82 |
United Setting Professional Modifier None (both parts) Typical Low $48.98 Median $72.44 Typical High $177.83 | Professional | None (both parts) | $48.98 | $72.44 | $177.83 |
3 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 TC · Technical part Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | TC · Technical part | $81.28 | $93.33 | $93.33 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $83.18 Median $131.83 Typical High $208.93 | Professional | TC · Technical part | $83.18 | $131.83 | $208.93 |
Horizon BCBS Setting Professional Modifier TC · Technical part Typical Low $81.28 Median $104.71 Typical High $134.90 | Professional | TC · Technical part | $81.28 | $104.71 | $134.90 |
Where New Jersey sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 34th of 51
$93.33
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.