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 $2,884.03 Median $2,884.03 Typical High $5,370.32 | Professional | None | $2,884.03 | $2,884.03 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $5,011.87 Median $7,079.46 Typical High $7,244.36 | Professional | None | $5,011.87 | $7,079.46 | $7,244.36 |
Horizon BCBS Setting Professional Modifier None Typical Low $5,248.07 Median $5,370.32 Typical High $12,882.50 | Professional | None | $5,248.07 | $5,370.32 | $12,882.50 |
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 $3,090.30 Median $4,365.16 Typical High $10,471.29 | Professional | None | $3,090.30 | $4,365.16 | $10,471.29 |
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 $1,445.44 Median $1,445.44 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $1,071.52 | Professional | 53 · Discontinued | $575.44 | $575.44 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,187.76 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,187.76 | $2,187.76 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $436.52 Typical High $794.33 | Professional | 55 · Aftercare only | $436.52 | $436.52 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $537.03 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $3,715.35 |
Where New Jersey sits
The same service costs 22.9 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· 36th of 51
$4,786
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.