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 $1,737.80 Median $4,570.88 Typical High $11,748.98 | Facility | None | $1,737.80 | $4,570.88 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,737.80 | $2,511.89 | $4,570.88 |
Emblem Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,630.78 Typical High $3,715.35 | Professional | None | $2,570.40 | $3,630.78 | $3,715.35 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $6,456.54 | Professional | None | $2,344.23 | $2,754.23 | $6,456.54 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $5,888.44 | Professional | None | $1,659.59 | $2,344.23 | $5,888.44 |
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 $870.96 Median $870.96 Typical High $1,548.82 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $616.60 | Professional | 53 · Discontinued | $354.81 | $354.81 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $457.09 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $309.03 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $2,137.96 |
Where New Jersey sits
The same service costs 5.8 times more in Alaska than in Texas. 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· 42nd of 51
$2,512
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.