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 $169.82 Median $3,467.37 Typical High $10,000.00 | Facility | None | $169.82 | $3,467.37 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $354.81 | Professional | None | $144.54 | $208.93 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | None | $120.23 | $147.91 | $147.91 |
AmeriHealth Setting Facility Modifier None Typical Low $1,148.15 Median $2,398.83 Typical High $5,754.40 | Facility | None | $1,148.15 | $2,398.83 | $5,754.40 |
AmeriHealth Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $2,187.76 | Professional | None | $346.74 | $467.74 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $1,659.59 | Facility | None | $208.93 | $371.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $436.52 | Professional | None | $120.23 | $204.17 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $446.68 | Professional | None | $316.23 | $426.58 | $446.68 |
Horizon BCBS Setting Facility Modifier None Typical Low $316.23 Median $575.44 Typical High $2,691.53 | Facility | None | $316.23 | $575.44 | $2,691.53 |
Horizon BCBS Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $446.68 | Professional | None | $186.21 | $323.59 | $446.68 |
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 $89.13 Median $158.49 Typical High $371.54 | Professional | None | $89.13 | $158.49 | $371.54 |
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 $72.44 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $72.44 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $28.84 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $107.15 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $21.38 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $147.91 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $100.00 | $147.91 | $173.78 |
Where New Jersey sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$240
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.