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 $190.55 Median $4,466.84 Typical High $9,772.37 | Facility | None | $190.55 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $389.05 | Professional | None | $158.49 | $234.42 | $389.05 |
AmeriHealth Setting Facility Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $4,466.84 | Facility | None | $1,230.27 | $2,570.40 | $4,466.84 |
AmeriHealth Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $245.47 | Professional | None | $128.82 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $776.25 Typical High $2,187.76 | Facility | None | $436.52 | $776.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $478.63 | Professional | None | $131.83 | $223.87 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $501.19 | Professional | None | $354.81 | $478.63 | $501.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $2,884.03 | Facility | None | $602.56 | $1,071.52 | $2,884.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $501.19 | Professional | None | $204.17 | $363.08 | $501.19 |
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 $97.72 Median $177.83 Typical High $416.87 | Professional | None | $97.72 | $177.83 | $416.87 |
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 $79.43 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $79.43 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $23.44 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.85 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $194.98 |
Where New Jersey sits
The same service costs 3.6 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· 48th of 51
$263
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.