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 $776.25 Median $10,232.93 Typical High $19,952.62 | Facility | None | $776.25 | $10,232.93 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,096.48 | Professional | None | $676.08 | $776.25 | $1,096.48 |
AmeriHealth Setting Facility Modifier None Typical Low $489.78 Median $9,120.11 Typical High $72,443.60 | Facility | None | $489.78 | $9,120.11 | $72,443.60 |
Cigna Setting Facility Modifier None Typical Low $8,511.38 Median $15,848.93 Typical High $47,863.01 | Facility | None | $8,511.38 | $15,848.93 | $47,863.01 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Horizon BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $14,454.40 Typical High $48,977.88 | Facility | None | $6,918.31 | $14,454.40 | $48,977.88 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,623.41 Typical High $41,686.94 | Facility | None | $1,659.59 | $5,623.41 | $41,686.94 |
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 $338.84 Median $389.05 Typical High $549.54 | Professional | 52 · Reduced service | $338.84 | $389.05 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $154.88 Typical High $218.78 | Professional | 53 · Discontinued | $134.90 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $831.76 | Professional | 54 · Surgery only | $501.19 | $588.84 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $165.96 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $109.65 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $109.65 |
Where New Jersey sits
The same service costs 281.8 times more in Minnesota than in Montana. 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
$6,166
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.