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 $109.65 Median $239.88 Typical High $10,471.29 | Facility | None | $109.65 | $239.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $251.19 | Professional | None | $109.65 | $186.21 | $251.19 |
AmeriHealth Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $489.78 | Professional | None | $204.17 | $338.84 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $2,691.53 | Facility | None | $338.84 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $407.38 | Professional | None | $134.90 | $223.87 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $588.84 | Professional | None | $426.58 | $588.84 | $588.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $436.52 Median $831.76 Typical High $3,801.89 | Facility | None | $436.52 | $831.76 | $3,801.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $467.74 | Professional | None | $181.97 | $323.59 | $467.74 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $323.59 | Professional | None | $123.03 | $181.97 | $323.59 |
7 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 $54.95 Median $93.33 Typical High $120.23 | Professional | 52 · Reduced service | $54.95 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $138.04 Typical High $181.97 | Professional | 54 · Surgery only | $81.28 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $28.18 Typical High $36.31 | Professional | 55 · Aftercare only | $16.22 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $18.62 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.96 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $128.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $75.86 | $128.82 | $169.82 |
Ambetter Setting Professional Modifier 51 · Multiple procedures + 59 · Distinct service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 51 · Multiple procedures + 59 · Distinct service | $186.21 | $186.21 | $186.21 |
Where New Jersey sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$191
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.