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 $213.80 Median $4,466.84 Typical High $9,772.37 | Facility | None | $213.80 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $407.38 | Professional | None | $177.83 | $251.19 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $2,187.76 | Facility | None | $676.08 | $1,348.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $512.86 | Professional | None | $147.91 | $251.19 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $549.54 | Professional | None | $389.05 | $524.81 | $549.54 |
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 $229.09 Median $389.05 Typical High $562.34 | Professional | None | $229.09 | $389.05 | $562.34 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $446.68 | Professional | None | $109.65 | $194.98 | $446.68 |
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 $89.13 Median $125.89 Typical High $147.91 | Professional | 52 · Reduced service | $89.13 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $58.88 | Professional | 53 · Discontinued | $35.48 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $134.90 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.02 Typical High $44.67 | Professional | 55 · Aftercare only | $26.92 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $177.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $125.89 | $177.83 | $208.93 |
Where New Jersey sits
The same service costs 4.0 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
$295
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.