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 $758.58 Median $4,466.84 Typical High $9,772.37 | Facility | None | $758.58 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,258.93 | Professional | None | $660.69 | $758.58 | $1,258.93 |
AmeriHealth Setting Professional Modifier None Typical Low $616.60 Median $1,122.02 Typical High $1,584.89 | Professional | None | $616.60 | $1,122.02 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,819.70 Typical High $2,570.40 | Facility | None | $933.25 | $1,819.70 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,548.82 | Professional | None | $524.81 | $851.14 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,513.56 | $1,621.81 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,659.59 | $3,162.28 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,621.81 | Professional | None | $812.83 | $1,148.15 | $1,621.81 |
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 $389.05 Median $602.56 Typical High $1,380.38 | Professional | None | $389.05 | $602.56 | $1,380.38 |
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 $331.13 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $331.13 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $131.83 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $489.78 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $66.07 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $630.96 |
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· 44th of 51
$912
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.