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 $1,000.00 Median $4,897.79 Typical High $10,964.78 | Facility | None | $1,000.00 | $4,897.79 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $575.44 | Professional | None | $234.42 | $380.19 | $575.44 |
AmeriHealth Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $724.44 | $2,818.38 | $4,786.30 |
AmeriHealth Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $407.38 | Professional | None | $213.80 | $275.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $416.87 Typical High $1,659.59 | Facility | None | $234.42 | $416.87 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $446.68 | Professional | None | $186.21 | $251.19 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $489.78 | Professional | None | $363.08 | $489.78 | $489.78 |
Horizon BCBS Setting Facility Modifier None Typical Low $346.74 Median $630.96 Typical High $2,089.30 | Facility | None | $346.74 | $630.96 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $562.34 | Professional | None | $229.09 | $346.74 | $562.34 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $371.54 | Professional | None | $162.18 | $245.47 | $371.54 |
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 $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $114.82 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $45.71 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $169.82 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $33.88 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $22.91 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $158.49 | $263.03 | $295.12 |
Where New Jersey sits
The same service costs 4.2 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· 41st of 51
$309
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.