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 $245.47 Median $4,466.84 Typical High $9,772.37 | Facility | None | $245.47 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $549.54 | Professional | None | $229.09 | $363.08 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $363.08 | Professional | None | $251.19 | $251.19 | $363.08 |
AmeriHealth Setting Facility Modifier None Typical Low $630.96 Median $7,585.78 Typical High $15,135.61 | Facility | None | $630.96 | $7,585.78 | $15,135.61 |
AmeriHealth Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $1,096.48 | Professional | None | $295.12 | $537.03 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,698.24 Typical High $2,570.40 | Facility | None | $831.76 | $1,698.24 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $831.76 | Professional | None | $218.78 | $338.84 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $371.54 Typical High $562.34 | Professional | None | $61.66 | $371.54 | $562.34 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $7,943.28 | Facility | None | $1,584.89 | $2,818.38 | $7,943.28 |
Horizon BCBS Setting Professional Modifier None Typical Low $218.78 Median $426.58 Typical High $1,023.29 | Professional | None | $218.78 | $426.58 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $758.58 | Professional | None | $162.18 | $281.84 | $758.58 |
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 $114.82 Median $151.36 Typical High $229.09 | Professional | 52 · Reduced service | $114.82 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $229.09 Typical High $338.84 | Professional | 54 · Surgery only | $173.78 | $229.09 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $45.71 Typical High $67.61 | Professional | 55 · Aftercare only | $34.67 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $213.80 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $162.18 | $213.80 | $316.23 |
Where New Jersey sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 32nd of 51
$417
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.