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 $69.18 Median $107.15 Typical High $147.91 | Professional | None | $69.18 | $107.15 | $147.91 |
AmeriHealth Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $112.20 | Professional | None | $66.07 | $77.62 | $112.20 |
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 $52.48 Median $100.00 Typical High $213.80 | Professional | None | $52.48 | $100.00 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $223.87 | Professional | None | $158.49 | $213.80 | $223.87 |
Horizon BCBS Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $933.25 | Facility | None | $446.68 | $741.31 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $223.87 | Professional | None | $85.11 | $158.49 | $223.87 |
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 $39.81 Median $79.43 Typical High $177.83 | Professional | None | $39.81 | $79.43 | $177.83 |
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 $33.88 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $33.88 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $21.38 Typical High $24.55 | Professional | 53 · Discontinued | $13.80 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $81.28 Typical High $93.33 | Professional | 54 · Surgery only | $51.29 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $10.23 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.92 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $75.86 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $47.86 | $75.86 | $87.10 |
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· 49th of 51
$107
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.