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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | None | $912.01 | $912.01 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $1,380.38 | Professional | None | $870.96 | $1,380.38 | $1,380.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $10,471.29 Typical High $27,542.29 | Facility | None | $5,888.44 | $10,471.29 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,548.82 | Professional | None | $954.99 | $1,047.13 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,288.25 | Professional | None | $645.65 | $812.83 | $1,288.25 |
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 $457.09 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | 54 · Surgery only | $691.83 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $660.69 |
Where New Jersey sits
The same service costs 17.4 times more in Alaska than in Texas. 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· 41st of 51
$933
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.