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 $100.00 Median $134.90 Typical High $169.82 | Professional | None | $100.00 | $134.90 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $213.80 Typical High $1,659.59 | Facility | None | $120.23 | $213.80 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $223.87 | Professional | None | $75.86 | $104.71 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | None | $177.83 | $245.47 | $245.47 |
Horizon BCBS Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $6,309.57 | Facility | None | $169.82 | $309.03 | $6,309.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $251.19 | Professional | None | $102.33 | $173.78 | $251.19 |
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 $67.61 Median $97.72 Typical High $147.91 | Professional | None | $67.61 | $97.72 | $147.91 |
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 $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $50.12 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $19.95 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $74.13 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $15.14 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.00 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $95.50 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $69.18 | $95.50 | $109.65 |
Where New Jersey sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 51st of 51
$110
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.