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 $112.20 Median $3,548.13 Typical High $10,232.93 | Facility | None | $112.20 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $186.21 Typical High $239.88 | Professional | None | $100.00 | $186.21 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
AmeriHealth Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $660.69 | Professional | None | $208.93 | $363.08 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $1,778.28 | Facility | None | $549.54 | $1,096.48 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $288.40 | Professional | None | $77.62 | $158.49 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $354.81 | Professional | None | $229.09 | $346.74 | $354.81 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,862.09 Typical High $5,888.44 | Facility | None | $1,023.29 | $1,862.09 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $338.84 | Professional | None | $104.71 | $229.09 | $338.84 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $213.80 | Professional | None | $69.18 | $134.90 | $213.80 |
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 $50.12 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $50.12 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $19.95 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $128.82 Typical High $158.49 | Professional | 54 · Surgery only | $75.86 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $15.14 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.00 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $120.23 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $70.79 | $120.23 | $147.91 |
Where New Jersey sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 47th of 51
$148
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.