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 $95.50 Median $1,380.38 Typical High $9,772.37 | Facility | None | $95.50 | $1,380.38 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $257.04 | Professional | None | $91.20 | $125.89 | $257.04 |
AmeriHealth Setting Facility Modifier None Typical Low $9,549.93 Median $16,595.87 Typical High $26,302.68 | Facility | None | $9,549.93 | $16,595.87 | $26,302.68 |
AmeriHealth Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $338.84 | Professional | None | $97.72 | $165.96 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $239.88 Typical High $1,659.59 | Facility | None | $134.90 | $239.88 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $323.59 | Professional | None | $102.33 | $177.83 | $323.59 |
Emblem Health Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | None | $194.98 | $302.00 | $302.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $165.96 Median $309.03 Typical High $758.58 | Facility | None | $165.96 | $309.03 | $758.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $398.11 | Professional | None | $100.00 | $181.97 | $398.11 |
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 $100.00 Median $158.49 Typical High $295.12 | Professional | None | $100.00 | $158.49 | $295.12 |
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 $45.71 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $45.71 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $18.20 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $67.61 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.12 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $89.13 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $63.10 | $89.13 | $104.71 |
Where New Jersey sits
The same service costs 3.6 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· 29th of 51
$178
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.