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 $602.56 Median $4,570.88 Typical High $10,471.29 | Facility | None | $602.56 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $954.99 | Professional | None | $524.81 | $602.56 | $954.99 |
AmeriHealth Setting Facility Modifier None Typical Low $2,089.30 Median $8,317.64 Typical High $17,378.01 | Facility | None | $2,089.30 | $8,317.64 | $17,378.01 |
AmeriHealth Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $562.34 | Professional | None | $354.81 | $416.87 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,995.26 Typical High $2,884.03 | Facility | None | $933.25 | $1,995.26 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $1,258.93 | Professional | None | $407.38 | $691.83 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,258.93 | Professional | None | $870.96 | $1,174.90 | $1,258.93 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $7,585.78 | Facility | None | $1,698.24 | $3,162.28 | $7,585.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,348.96 | Professional | None | $645.65 | $891.25 | $1,348.96 |
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 $309.03 Median $467.74 Typical High $1,096.48 | Professional | None | $309.03 | $467.74 | $1,096.48 |
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 $263.03 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $104.71 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $60.26 Typical High $69.18 | Professional | 56 · Pre-op care only | $52.48 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $478.63 |
Where New Jersey sits
The same service costs 4.6 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· 46th of 51
$692
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.