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 $120.23 Median $2,754.23 Typical High $9,772.37 | Facility | None | $120.23 | $2,754.23 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $234.42 | Professional | None | $102.33 | $158.49 | $234.42 |
AmeriHealth Setting Facility Modifier None Typical Low $5,011.87 Median $10,471.29 Typical High $13,182.57 | Facility | None | $5,011.87 | $10,471.29 | $13,182.57 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $234.42 Typical High $371.54 | Facility | None | $134.90 | $234.42 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $288.40 | Professional | None | $85.11 | $162.18 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $309.03 | Professional | None | $213.80 | $288.40 | $309.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $223.87 Median $416.87 Typical High $3,019.95 | Facility | None | $223.87 | $416.87 | $3,019.95 |
Horizon BCBS Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $338.84 | Professional | None | $112.20 | $229.09 | $338.84 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $251.19 | Professional | None | $56.23 | $107.15 | $251.19 |
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 $51.29 Median $70.79 Typical High $104.71 | Professional | 52 · Reduced service | $51.29 | $70.79 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.18 Typical High $42.66 | Professional | 53 · Discontinued | $20.42 | $28.18 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $107.15 Typical High $158.49 | Professional | 54 · Surgery only | $77.62 | $107.15 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.38 Typical High $31.62 | Professional | 55 · Aftercare only | $15.49 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.13 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.23 | $14.13 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $100.00 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $72.44 | $100.00 | $147.91 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 47th of 51
$158
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.