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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $5,011.87 | Professional | None | $2,630.27 | $2,630.27 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $4,786.30 Median $6,606.93 Typical High $6,760.83 | Professional | None | $4,786.30 | $6,606.93 | $6,760.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $12,022.64 | Professional | None | $5,011.87 | $5,128.61 | $12,022.64 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $2,884.03 Median $4,073.80 Typical High $9,772.37 | Professional | None | $2,884.03 | $4,073.80 | $9,772.37 |
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 $1,318.26 Median $1,318.26 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $1,000.00 | Professional | 53 · Discontinued | $524.81 | $524.81 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $758.58 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $501.19 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $3,548.13 |
Where New Jersey sits
The same service costs 24.0 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· 39th of 51
$4,467
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.