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 $85.11 Median $512.86 Typical High $8,912.51 | Facility | None | $85.11 | $512.86 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $162.18 | Professional | None | $72.44 | $95.50 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | None | $144.54 | $144.54 | $162.18 |
AmeriHealth Setting Facility Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $8,511.38 | Facility | None | $2,187.76 | $3,548.13 | $8,511.38 |
AmeriHealth Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $295.12 | Professional | None | $114.82 | $147.91 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $169.82 Typical High $354.81 | Facility | None | $89.13 | $169.82 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $199.53 | Professional | None | $79.43 | $104.71 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $8.13 Median $81.28 Typical High $177.83 | Professional | None | $8.13 | $81.28 | $177.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $758.58 | Facility | None | $141.25 | $269.15 | $758.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $199.53 | Professional | None | $97.72 | $141.25 | $199.53 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $169.82 | Professional | None | $53.70 | $74.13 | $169.82 |
6 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 $36.31 Median $42.66 Typical High $51.29 | Professional | 52 · Reduced service | $36.31 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.98 Typical High $20.42 | Professional | 53 · Discontinued | $14.45 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $63.10 Typical High $75.86 | Professional | 54 · Surgery only | $53.70 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $10.72 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.51 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.24 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $50.12 Median $58.88 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $50.12 | $58.88 | $70.79 |
Where New Jersey sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 45th of 51
$115
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.