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 $95.50 Median $134.90 Typical High $190.55 | Professional | None | $95.50 | $134.90 | $190.55 |
AmeriHealth Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $288.40 | Professional | None | $165.96 | $199.53 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $208.93 Typical High $371.54 | Facility | None | $114.82 | $208.93 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $269.15 | Professional | None | $72.44 | $131.83 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $288.40 | Professional | None | $199.53 | $269.15 | $288.40 |
Horizon BCBS Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $758.58 | Facility | None | $208.93 | $380.19 | $758.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $281.84 | Professional | None | $114.82 | $208.93 | $281.84 |
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 $53.70 Median $102.33 Typical High $234.42 | Professional | None | $53.70 | $102.33 | $234.42 |
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 $47.86 Median $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $47.86 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $19.05 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $70.79 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $14.13 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $9.55 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $95.50 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $66.07 | $95.50 | $109.65 |
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· 44th of 51
$155
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.