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 $125.89 Median $3,467.37 Typical High $10,000.00 | Facility | None | $125.89 | $3,467.37 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $204.17 | Professional | None | $125.89 | $141.25 | $204.17 |
AmeriHealth Setting Facility Modifier None Typical Low $2,344.23 Median $8,128.31 Typical High $12,589.25 | Facility | None | $2,344.23 | $8,128.31 | $12,589.25 |
AmeriHealth Setting Professional Modifier None Typical Low $61.66 Median $162.18 Typical High $407.38 | Professional | None | $61.66 | $162.18 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $186.21 Typical High $1,659.59 | Facility | None | $104.71 | $186.21 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $288.40 | Professional | None | $134.90 | $194.98 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | None | $169.82 | $229.09 | $229.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $141.25 Median $263.03 Typical High $1,148.15 | Facility | None | $141.25 | $263.03 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $316.23 | Professional | None | $112.20 | $154.88 | $316.23 |
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 $64.57 Median $91.20 Typical High $199.53 | Professional | None | $64.57 | $91.20 | $199.53 |
7 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 $63.10 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $63.10 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $25.12 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $104.71 Typical High $117.49 | Professional | 54 · Surgery only | $95.50 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $23.44 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.59 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $97.72 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $89.13 | $97.72 | $109.65 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 50 · Both sides | $199.53 | $199.53 | $199.53 |
Where New Jersey sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 39th of 51
$145
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.