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 $616.60 Median $5,248.07 Typical High $11,748.98 | Facility | None | $616.60 | $5,248.07 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $616.60 Typical High $758.58 | Professional | None | $346.74 | $616.60 | $758.58 |
AmeriHealth Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $489.78 | Professional | None | $269.15 | $269.15 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $380.19 Typical High $1,659.59 | Facility | None | $213.80 | $380.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $588.84 | Professional | None | $213.80 | $245.47 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $489.78 Typical High $660.69 | Professional | None | $204.17 | $489.78 | $660.69 |
Horizon BCBS Setting Facility Modifier None Typical Low $309.03 Median $562.34 Typical High $2,089.30 | Facility | None | $309.03 | $562.34 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $851.14 | Professional | None | $269.15 | $338.84 | $851.14 |
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 $190.55 Median $257.04 Typical High $588.84 | Professional | None | $190.55 | $257.04 | $588.84 |
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 $295.12 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $478.63 |
Where New Jersey sits
The same service costs 5.0 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
$372
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.