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 $3,388.44 Typical High $10,000.00 | Facility | None | $112.20 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $213.80 | Professional | None | $95.50 | $151.36 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
AmeriHealth Setting Professional Modifier None Typical Low $102.33 Median $263.03 Typical High $478.63 | Professional | None | $102.33 | $263.03 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $1,659.59 | Facility | None | $204.17 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $275.42 | Professional | None | $91.20 | $151.36 | $275.42 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | None | $275.42 | $380.19 | $380.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $275.42 Median $501.19 Typical High $4,466.84 | Facility | None | $275.42 | $501.19 | $4,466.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $316.23 | Professional | None | $107.15 | $213.80 | $316.23 |
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 $128.82 Typical High $208.93 | Professional | None | $69.18 | $128.82 | $208.93 |
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 $47.86 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $47.86 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $19.05 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $70.79 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $14.45 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.55 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $107.15 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $66.07 | $107.15 | $128.82 |
Where New Jersey sits
The same service costs 3.5 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· 48th of 51
$151
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.