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 $691.83 Median $4,570.88 Typical High $10,232.93 | Facility | None | $691.83 | $4,570.88 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,174.90 | Professional | None | $616.60 | $724.44 | $1,174.90 |
AmeriHealth Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,479.11 | Professional | None | $851.14 | $1,047.13 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,949.84 Typical High $2,884.03 | Facility | None | $933.25 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $1,479.11 | Professional | None | $467.74 | $812.83 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,412.54 | $1,513.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $7,762.47 | Facility | None | $1,659.59 | $3,019.95 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,737.80 | Professional | None | $741.31 | $1,122.02 | $1,737.80 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $1,288.25 | Professional | None | $346.74 | $549.54 | $1,288.25 |
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 $309.03 Median $363.08 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $147.91 Typical High $165.96 | Professional | 53 · Discontinued | $123.03 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $457.09 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $91.20 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $575.44 |
Where New Jersey sits
The same service costs 4.4 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· 43rd of 51
$851
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.