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 $141.25 Median $3,311.31 Typical High $10,000.00 | Facility | None | $141.25 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $269.15 | Professional | None | $120.23 | $158.49 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
AmeriHealth Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $3,467.37 | Facility | None | $1,288.25 | $2,187.76 | $3,467.37 |
AmeriHealth Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $181.97 | Professional | None | $100.00 | $123.03 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,995.26 | Facility | None | $616.60 | $1,202.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $331.13 | Professional | None | $102.33 | $173.78 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $380.19 | Professional | None | $269.15 | $354.81 | $380.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $2,290.87 Typical High $6,165.95 | Facility | None | $1,202.26 | $2,290.87 | $6,165.95 |
Horizon BCBS Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $363.08 | Professional | None | $158.49 | $257.04 | $363.08 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $295.12 | Professional | None | $81.28 | $134.90 | $295.12 |
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 $60.26 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $23.99 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $89.13 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $112.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $83.18 | $112.20 | $134.90 |
Where New Jersey sits
The same service costs 4.6 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
$191
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.