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 $114.82 Median $6,760.83 Typical High $11,748.98 | Facility | None | $114.82 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $186.21 | Professional | None | $87.10 | $114.82 | $186.21 |
AmeriHealth Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $354.81 | Professional | None | $120.23 | $186.21 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $173.78 Typical High $1,659.59 | Facility | None | $97.72 | $173.78 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $281.84 | Professional | None | $77.62 | $114.82 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $199.53 | Professional | None | $131.83 | $199.53 | $199.53 |
Horizon BCBS Setting Facility Modifier None Typical Low $134.90 Median $245.47 Typical High $933.25 | Facility | None | $134.90 | $245.47 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $302.00 | Professional | None | $81.28 | $128.82 | $302.00 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $229.09 | Professional | None | $63.10 | $95.50 | $229.09 |
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 $43.65 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $43.65 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.42 Typical High $23.44 | Professional | 53 · Discontinued | $17.38 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $77.62 Typical High $87.10 | Professional | 54 · Surgery only | $64.57 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.23 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.71 | $10.23 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $72.44 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $60.26 | $72.44 | $81.28 |
Where New Jersey sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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
$117
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.