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 $158.49 Median $3,388.44 Typical High $10,000.00 | Facility | None | $158.49 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $275.42 | Professional | None | $134.90 | $169.82 | $275.42 |
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 $173.78 Median $309.03 Typical High $1,659.59 | Facility | None | $173.78 | $309.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $363.08 | Professional | None | $112.20 | $199.53 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $371.54 | Professional | None | $263.03 | $354.81 | $371.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $263.03 Median $478.63 Typical High $6,025.60 | Facility | None | $263.03 | $478.63 | $6,025.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $389.05 | Professional | None | $173.78 | $263.03 | $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 $85.11 Median $131.83 Typical High $309.03 | Professional | None | $85.11 | $131.83 | $309.03 |
7 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 $67.61 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $67.61 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.88 Typical High $39.81 | Professional | 53 · Discontinued | $26.92 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $100.00 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.12 Typical High $29.51 | Professional | 55 · Aftercare only | $19.95 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.49 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $117.49 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $93.33 | $117.49 | $138.04 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | GC · Resident with teaching physician | $208.93 | $208.93 | $208.93 |
Where New Jersey sits
The same service costs 3.9 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· 48th of 51
$195
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.