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 $1,258.93 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,258.93 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $257.04 | Professional | None | $109.65 | $138.04 | $257.04 |
AmeriHealth Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $223.87 | Professional | None | $69.18 | $97.72 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $354.81 | Facility | None | $100.00 | $181.97 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $199.53 | Professional | None | $93.33 | $123.03 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $234.42 | Professional | None | $173.78 | $234.42 | $234.42 |
Horizon BCBS Setting Facility Modifier None Typical Low $165.96 Median $316.23 Typical High $1,202.26 | Facility | None | $165.96 | $316.23 | $1,202.26 |
Horizon BCBS Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $245.47 | Professional | None | $114.82 | $173.78 | $245.47 |
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 $83.18 Median $114.82 Typical High $151.36 | Professional | None | $83.18 | $114.82 | $151.36 |
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 $54.95 Median $69.18 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.18 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $104.71 Typical High $107.15 | Professional | 54 · Surgery only | $83.18 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.89 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.80 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $97.72 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $77.62 | $97.72 | $100.00 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 50 · Both sides | $223.87 | $223.87 | $223.87 |
Where New Jersey sits
The same service costs 4.1 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· 43rd of 51
$138
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.