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 $93.33 Median $4,466.84 Typical High $9,772.37 | Facility | None | $93.33 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $165.96 | Professional | None | $75.86 | $100.00 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
AmeriHealth Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $234.42 | Professional | None | $138.04 | $162.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $1,659.59 | Facility | None | $125.89 | $223.87 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $208.93 | Professional | None | $67.61 | $117.49 | $208.93 |
Emblem Health Setting Professional Modifier None Typical Low $16.22 Median $97.72 Typical High $194.98 | Professional | None | $16.22 | $97.72 | $194.98 |
Horizon BCBS Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $2,691.53 | Facility | None | $194.98 | $354.81 | $2,691.53 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $239.88 | Professional | None | $102.33 | $162.18 | $239.88 |
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 $52.48 Median $83.18 Typical High $186.21 | Professional | None | $52.48 | $83.18 | $186.21 |
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 $38.02 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $38.02 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $15.14 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $74.13 Typical High $89.13 | Professional | 54 · Surgery only | $56.23 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $11.22 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.59 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $69.18 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $52.48 | $69.18 | $83.18 |
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· 46th of 51
$126
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.