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 $91.20 Median $2,570.40 Typical High $9,772.37 | Facility | None | $91.20 | $2,570.40 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $239.88 | Professional | None | $74.13 | $128.82 | $239.88 |
AmeriHealth Setting Facility Modifier None Typical Low $6,918.31 Median $11,481.54 Typical High $17,378.01 | Facility | None | $6,918.31 | $11,481.54 | $17,378.01 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $512.86 | Facility | None | $223.87 | $354.81 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $181.97 Typical High $288.40 | Professional | None | $83.18 | $181.97 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $8.13 Median $95.50 Typical High $416.87 | Professional | None | $8.13 | $95.50 | $416.87 |
Horizon BCBS Setting Facility Modifier None Typical Low $363.08 Median $676.08 Typical High $2,884.03 | Facility | None | $363.08 | $676.08 | $2,884.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $100.00 Median $229.09 Typical High $389.05 | Professional | None | $100.00 | $229.09 | $389.05 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $56.23 Median $138.04 Typical High $257.04 | Professional | None | $56.23 | $138.04 | $257.04 |
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 $37.15 Median $64.57 Typical High $79.43 | Professional | 52 · Reduced service | $37.15 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $25.70 Typical High $31.62 | Professional | 53 · Discontinued | $14.79 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $95.50 Typical High $120.23 | Professional | 54 · Surgery only | $54.95 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $10.96 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.88 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.41 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $89.13 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $51.29 | $89.13 | $112.20 |
Where New Jersey sits
The same service costs 4.1 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· 50th of 51
$158
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.