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 $1.95 Median $4,786.30 Typical High $10,471.29 | Facility | None | $1.95 | $4,786.30 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.95 Typical High $3,548.13 | Professional | None | $1.58 | $1.95 | $3,548.13 |
AmeriHealth Setting Facility Modifier None Typical Low $1.95 Median $8.13 Typical High $4,073.80 | Facility | None | $1.95 | $8.13 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $19.50 Typical High $33.88 | Facility | None | $8.32 | $19.50 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $9.33 | Professional | None | $1.26 | $1.26 | $9.33 |
Emblem Health Setting Professional Modifier None Typical Low $3.72 Median $4.68 Typical High $5.13 | Professional | None | $3.72 | $4.68 | $5.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $14,454.40 Typical High $25,703.96 | Facility | None | $7,244.36 | $14,454.40 | $25,703.96 |
Horizon BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
United Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
United Setting Professional Modifier None Typical Low $1.51 Median $3.02 Typical High $6.03 | Professional | None | $1.51 | $3.02 | $6.03 |
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 $0.79 Median $0.79 Typical High $1.29 | Professional | 52 · Reduced service | $0.79 | $0.79 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.51 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.20 Median $1.20 Typical High $1.91 | Professional | 54 · Surgery only | $1.20 | $1.20 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.38 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.26 |
Where New Jersey sits
The same service costs 25.7 times more in Kansas than in Delaware. 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· 24th of 51
$6.03
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.