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 $251.19 Median $4,570.88 Typical High $10,000.00 | Facility | None | $251.19 | $4,570.88 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $467.74 | Professional | None | $218.78 | $302.00 | $467.74 |
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 $173.78 Median $309.03 Typical High $602.56 | Professional | None | $173.78 | $309.03 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $630.96 | Professional | None | $446.68 | $602.56 | $630.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $6,760.83 | Facility | None | $1,174.90 | $1,995.26 | $6,760.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $676.08 | Professional | None | $275.42 | $457.09 | $676.08 |
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 $128.82 Median $223.87 Typical High $524.81 | Professional | None | $128.82 | $223.87 | $524.81 |
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 $109.65 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $109.65 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $43.65 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $162.18 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.88 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $151.36 | $208.93 | $245.47 |
Where New Jersey sits
The same service costs 3.9 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· 49th of 51
$347
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.