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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $190.55 | Professional | None | $69.18 | $112.20 | $190.55 |
AmeriHealth Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $263.03 | Professional | None | $169.82 | $169.82 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $446.68 Typical High $537.03 | Facility | None | $426.58 | $446.68 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $100.00 Typical High $239.88 | Professional | None | $39.81 | $100.00 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $229.09 | Professional | None | $169.82 | $223.87 | $229.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $933.25 | Facility | None | $446.68 | $741.31 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $275.42 | Professional | None | $177.83 | $208.93 | $275.42 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $831.76 | Facility | None | $389.05 | $389.05 | $831.76 |
United Setting Professional Modifier None Typical Low $20.42 Median $69.18 Typical High $190.55 | Professional | None | $20.42 | $69.18 | $190.55 |
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 $34.67 Median $46.77 Typical High $91.20 | Professional | 52 · Reduced service | $34.67 | $46.77 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $18.62 Typical High $36.31 | Professional | 53 · Discontinued | $13.80 | $18.62 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $69.18 Typical High $134.90 | Professional | 54 · Surgery only | $51.29 | $69.18 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.80 Typical High $27.54 | Professional | 55 · Aftercare only | $10.23 | $13.80 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $9.33 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.92 | $9.33 | $18.20 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 40th of 51
$138
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.