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 $186.21 Median $3,548.13 Typical High $10,232.93 | Facility | None | $186.21 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $371.54 | Professional | None | $158.49 | $223.87 | $371.54 |
AmeriHealth Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $1,000.00 | Professional | None | $173.78 | $181.97 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $288.40 Typical High $416.87 | Facility | None | $190.55 | $288.40 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $457.09 | Professional | None | $128.82 | $229.09 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $478.63 | Professional | None | $338.84 | $457.09 | $478.63 |
Horizon BCBS Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $6,165.95 | Facility | None | $331.13 | $588.84 | $6,165.95 |
Horizon BCBS Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $489.78 | Professional | None | $204.17 | $346.74 | $489.78 |
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 $95.50 Median $169.82 Typical High $398.11 | Professional | None | $95.50 | $169.82 | $398.11 |
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 $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $79.43 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $31.62 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $117.49 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.85 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $186.21 |
Where New Jersey sits
The same service costs 3.9 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
$257
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.