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 $245.47 Median $4,570.88 Typical High $10,232.93 | Facility | None | $245.47 | $4,570.88 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $524.81 | Professional | None | $245.47 | $316.23 | $524.81 |
AmeriHealth Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $933.25 | Professional | None | $251.19 | $263.03 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $812.83 Typical High $2,691.53 | Facility | None | $489.78 | $812.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $645.65 | Professional | None | $213.80 | $354.81 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $676.08 | Professional | None | $478.63 | $645.65 | $676.08 |
Horizon BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,023.29 Typical High $2,754.23 | Facility | None | $575.44 | $1,023.29 | $2,754.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $269.15 Median $489.78 Typical High $707.95 | Professional | None | $269.15 | $489.78 | $707.95 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,412.54 Typical High $3,890.45 | Facility | None | $309.03 | $1,412.54 | $3,890.45 |
United Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $562.34 | Professional | None | $128.82 | $239.88 | $562.34 |
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 $123.03 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $123.03 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $48.98 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $186.21 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $37.15 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $24.55 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $173.78 | $218.78 | $257.04 |
Where New Jersey sits
The same service costs 3.4 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· 47th of 51
$355
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.