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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $112.20 | Professional | None | $51.29 | $74.13 | $112.20 |
AmeriHealth Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $77.62 | Professional | None | $45.71 | $54.95 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $144.54 | Professional | None | $43.65 | $77.62 | $144.54 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $158.49 | Professional | None | $109.65 | $147.91 | $158.49 |
Horizon BCBS Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $933.25 | Facility | None | $446.68 | $676.08 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $165.96 | Professional | None | $67.61 | $112.20 | $165.96 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $31.62 Median $56.23 Typical High $125.89 | Professional | None | $31.62 | $56.23 | $125.89 |
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 $25.70 Median $36.31 Typical High $40.74 | Professional | 52 · Reduced service | $25.70 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $10.23 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $54.95 Typical High $61.66 | Professional | 54 · Surgery only | $38.90 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.96 Typical High $12.30 | Professional | 55 · Aftercare only | $7.76 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.41 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.13 | $7.41 | $8.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $36.31 Median $51.29 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $36.31 | $51.29 | $57.54 |
Where New Jersey sits
The same service costs 3.8 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· 50th of 51
$79.43
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.