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 $85.11 Median $125.89 Typical High $194.98 | Professional | None | $85.11 | $125.89 | $194.98 |
AmeriHealth Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $269.15 | Professional | None | $154.88 | $181.97 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $204.17 Typical High $371.54 | Facility | None | $112.20 | $204.17 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $120.23 Typical High $251.19 | Professional | None | $64.57 | $120.23 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $263.03 | Professional | None | $186.21 | $245.47 | $263.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $165.96 Median $316.23 Typical High $758.58 | Facility | None | $165.96 | $316.23 | $758.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $257.04 | Professional | None | $102.33 | $186.21 | $257.04 |
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 $47.86 Median $93.33 Typical High $208.93 | Professional | None | $47.86 | $93.33 | $208.93 |
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 $42.66 Median $63.10 Typical High $72.44 | Professional | 52 · Reduced service | $42.66 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $16.98 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $63.10 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $12.59 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.51 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $87.10 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $58.88 | $87.10 | $100.00 |
Where New Jersey sits
The same service costs 3.5 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· 45th of 51
$138
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.