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 $128.82 Median $2,754.23 Typical High $9,772.37 | Facility | None | $128.82 | $2,754.23 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $213.80 | Professional | None | $128.82 | $147.91 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $169.82 | Professional | None | $125.89 | $147.91 | $169.82 |
AmeriHealth Setting Facility Modifier None Typical Low $870.96 Median $3,981.07 Typical High $6,456.54 | Facility | None | $870.96 | $3,981.07 | $6,456.54 |
AmeriHealth Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $416.87 | Professional | None | $138.04 | $239.88 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $154.88 Typical High $389.05 | Facility | None | $81.28 | $154.88 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $288.40 | Professional | None | $151.36 | $199.53 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | None | $190.55 | $251.19 | $251.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $125.89 Median $234.42 Typical High $1,148.15 | Facility | None | $125.89 | $234.42 | $1,148.15 |
Horizon BCBS Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $309.03 | Professional | None | $114.82 | $169.82 | $309.03 |
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 $100.00 Typical High $213.80 | Professional | None | $64.57 | $100.00 | $213.80 |
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 $64.57 Median $72.44 Typical High $77.62 | Professional | 52 · Reduced service | $64.57 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $25.70 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $109.65 Typical High $117.49 | Professional | 54 · Surgery only | $97.72 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.88 Typical High $23.44 | Professional | 55 · Aftercare only | $19.50 | $21.88 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.88 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $102.33 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $91.20 | $102.33 | $109.65 |
Where New Jersey sits
The same service costs 3.9 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· 38th of 51
$155
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.