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 $346.74 Median $389.05 Typical High $426.58 | Professional | None | $346.74 | $389.05 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $4,570.88 Typical High $8,128.31 | Facility | None | $1,995.26 | $4,570.88 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | None | $436.52 | $512.86 | $512.86 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $10,232.93 Typical High $27,542.29 | Facility | None | $5,623.41 | $10,232.93 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $457.09 | Professional | None | $354.81 | $407.38 | $457.09 |
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 $199.53 Median $257.04 Typical High $416.87 | Professional | None | $199.53 | $257.04 | $416.87 |
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 $173.78 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $173.78 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $69.18 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $42.66 |
Where New Jersey sits
The same service costs 4.5 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· 44th of 51
$355
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.