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 $229.09 Median $4,466.84 Typical High $9,772.37 | Facility | None | $229.09 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $346.74 | Professional | None | $208.93 | $275.42 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
AmeriHealth Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $933.25 | Professional | None | $724.44 | $851.14 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,187.76 | Facility | None | $645.65 | $1,202.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $457.09 | Professional | None | $154.88 | $213.80 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $512.86 | Professional | None | $363.08 | $501.19 | $512.86 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,041.74 Typical High $6,309.57 | Facility | None | $1,047.13 | $2,041.74 | $6,309.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $512.86 | Professional | None | $213.80 | $346.74 | $512.86 |
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 $134.90 Median $204.17 Typical High $295.12 | Professional | None | $134.90 | $204.17 | $295.12 |
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 $104.71 Median $138.04 Typical High $151.36 | Professional | 52 · Reduced service | $104.71 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $41.69 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $208.93 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $27.54 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.89 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $194.98 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $147.91 | $194.98 | $213.80 |
Where New Jersey sits
The same service costs 4.3 times more in Alaska than in Utah. 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· 50th of 51
$224
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.