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 $199.53 Median $3,548.13 Typical High $10,232.93 | Facility | None | $199.53 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $346.74 | Professional | None | $169.82 | $213.80 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,995.26 | Facility | None | $616.60 | $1,202.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $446.68 | Professional | None | $141.25 | $234.42 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $467.74 | Professional | None | $331.13 | $446.68 | $467.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $6,165.95 | Facility | None | $1,122.02 | $2,137.96 | $6,165.95 |
Horizon BCBS Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $489.78 | Professional | None | $218.78 | $323.59 | $489.78 |
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 $107.15 Median $165.96 Typical High $389.05 | Professional | None | $107.15 | $165.96 | $389.05 |
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 $85.11 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $85.11 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $34.67 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $128.82 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $147.91 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $120.23 | $147.91 | $173.78 |
Where New Jersey sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 48th of 51
$251
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.