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 $275.42 Median $309.03 Typical High $512.86 | Professional | None | $275.42 | $309.03 | $512.86 |
AmeriHealth Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $537.03 | Professional | None | $295.12 | $295.12 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $309.03 Typical High $1,659.59 | Facility | None | $162.18 | $309.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $630.96 | Professional | None | $281.84 | $331.13 | $630.96 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $575.44 | Professional | None | $416.87 | $575.44 | $575.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $1,000.00 | Facility | None | $199.53 | $363.08 | $1,000.00 |
Horizon BCBS Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $691.83 | Professional | None | $309.03 | $363.08 | $691.83 |
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 $229.09 Median $295.12 Typical High $446.68 | Professional | None | $229.09 | $295.12 | $446.68 |
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 $138.04 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $138.04 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $54.95 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $204.17 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $33.11 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $229.09 |
Where New Jersey sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 42nd of 51
$309
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.