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 $190.55 Median $208.93 Typical High $363.08 | Professional | None | $190.55 | $208.93 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
AmeriHealth Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $389.05 | Professional | None | $204.17 | $204.17 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $380.19 | Facility | None | $141.25 | $245.47 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $436.52 | Professional | None | $199.53 | $234.42 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $389.05 | Professional | None | $281.84 | $389.05 | $389.05 |
Horizon BCBS Setting Facility Modifier None Typical Low $190.55 Median $354.81 Typical High $1,000.00 | Facility | None | $190.55 | $354.81 | $1,000.00 |
Horizon BCBS Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $489.78 | Professional | None | $223.87 | $257.04 | $489.78 |
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 $162.18 Median $199.53 Typical High $309.03 | Professional | None | $162.18 | $199.53 | $309.03 |
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 $95.50 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $38.02 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $141.25 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $31.62 Typical High $34.67 | Professional | 55 · Aftercare only | $28.18 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $147.91 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $131.83 | $147.91 | $162.18 |
Where New Jersey sits
The same service costs 5.1 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· 38th of 51
$224
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.