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 $3,801.89 Median $7,943.28 Typical High $12,022.64 | Facility | None | $3,801.89 | $7,943.28 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,023.29 | Professional | None | $478.63 | $616.60 | $1,023.29 |
AmeriHealth Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $794.33 | Professional | None | $467.74 | $467.74 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $616.60 Typical High $1,659.59 | Facility | None | $331.13 | $616.60 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $776.25 | Professional | None | $371.54 | $416.87 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $660.69 Typical High $831.76 | Professional | None | $162.18 | $660.69 | $831.76 |
Horizon BCBS Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $2,089.30 | Facility | None | $512.86 | $912.01 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $1,047.13 | Professional | None | $478.63 | $588.84 | $1,047.13 |
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 $346.74 Median $446.68 Typical High $630.96 | Professional | None | $346.74 | $446.68 | $630.96 |
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 $239.88 Median $309.03 Typical High $323.59 | Professional | 52 · Reduced service | $239.88 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $123.03 Typical High $128.82 | Professional | 53 · Discontinued | $95.50 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $93.33 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $61.66 Typical High $64.57 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $436.52 | $446.68 |
Where New Jersey sits
The same service costs 6.2 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· 42nd of 51
$550
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.