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 $218.78 Median $4,466.84 Typical High $9,772.37 | Facility | None | $218.78 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $478.63 | Professional | None | $213.80 | $275.42 | $478.63 |
AmeriHealth Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $1,348.96 | Professional | None | $489.78 | $660.69 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $478.63 Typical High $2,187.76 | Facility | None | $269.15 | $478.63 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $588.84 | Professional | None | $186.21 | $331.13 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $630.96 | Professional | None | $436.52 | $588.84 | $630.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $338.84 Median $616.60 Typical High $1,659.59 | Facility | None | $338.84 | $616.60 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $239.88 Median $457.09 Typical High $616.60 | Professional | None | $239.88 | $457.09 | $616.60 |
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 $112.20 Median $223.87 Typical High $489.78 | Professional | None | $112.20 | $223.87 | $489.78 |
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 $107.15 Median $138.04 Typical High $169.82 | Professional | 52 · Reduced service | $107.15 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $56.23 Typical High $67.61 | Professional | 53 · Discontinued | $42.66 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $158.49 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $31.62 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.38 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $194.98 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $147.91 | $194.98 | $239.88 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 43rd of 51
$324
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.