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 $4,466.84 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,466.84 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $8,912.51 | Professional | None | $4,786.30 | $4,786.30 | $8,912.51 |
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 $4,570.88 Median $5,370.32 Typical High $13,803.84 | Professional | None | $4,570.88 | $5,370.32 | $13,803.84 |
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 $4,365.16 Median $5,495.41 Typical High $14,454.40 | Professional | None | $4,365.16 | $5,495.41 | $14,454.40 |
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 $2,398.83 Median $2,398.83 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | 53 · Discontinued | $954.99 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $3,548.13 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,548.13 | $3,548.13 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $549.54 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,311.31 Median $3,311.31 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,311.31 | $3,311.31 | $3,801.89 |
Where New Jersey sits
The same service costs 9.1 times more in Alaska than in Arkansas. 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
$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.