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 $97.72 Median $147.91 Typical High $229.09 | Professional | None | $97.72 | $147.91 | $229.09 |
AmeriHealth Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $2,137.96 | Professional | None | $83.18 | $114.82 | $2,137.96 |
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 $74.13 Median $138.04 Typical High $288.40 | Professional | None | $74.13 | $138.04 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $309.03 | Professional | None | $213.80 | $288.40 | $309.03 |
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 $120.23 Median $218.78 Typical High $302.00 | Professional | None | $120.23 | $218.78 | $302.00 |
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 $56.23 Median $109.65 Typical High $245.47 | Professional | None | $56.23 | $109.65 | $245.47 |
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 $48.98 Median $74.13 Typical High $83.18 | Professional | 52 · Reduced service | $48.98 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $29.51 Typical High $33.11 | Professional | 53 · Discontinued | $19.50 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $109.65 Typical High $125.89 | Professional | 54 · Surgery only | $74.13 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.88 Typical High $25.12 | Professional | 55 · Aftercare only | $14.79 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.79 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.77 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $102.33 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $69.18 | $102.33 | $117.49 |
Where New Jersey sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 48th of 51
$151
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.