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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $2,290.87 | Professional | None | $812.83 | $1,096.48 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,862.09 | $1,862.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $3,235.94 | Professional | None | $1,174.90 | $1,380.38 | $3,235.94 |
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 $831.76 Median $1,174.90 Typical High $2,951.21 | Professional | None | $831.76 | $1,174.90 | $2,951.21 |
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 $407.38 Median $407.38 Typical High $758.58 | Professional | 52 · Reduced service | $407.38 | $407.38 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $302.00 | Professional | 53 · Discontinued | $165.96 | $165.96 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,148.15 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $229.09 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $151.36 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,071.52 |
Where New Jersey sits
The same service costs 6.3 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· 37th of 51
$1,288
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.