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 $2,754.23 Median $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $295.12 | Professional | None | $154.88 | $208.93 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $302.00 Typical High $426.58 | Facility | None | $194.98 | $302.00 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $426.58 | Professional | None | $144.54 | $245.47 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $478.63 | Professional | None | $338.84 | $446.68 | $478.63 |
Horizon BCBS Setting Facility Modifier None Typical Low $316.23 Median $575.44 Typical High $7,762.47 | Facility | None | $316.23 | $575.44 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $186.21 Median $346.74 Typical High $457.09 | Professional | None | $186.21 | $346.74 | $457.09 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $380.19 | Professional | None | $93.33 | $169.82 | $380.19 |
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 $77.62 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $77.62 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $30.90 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $117.49 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $23.44 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.49 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $144.54 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $109.65 | $144.54 | $177.83 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 45th of 51
$245
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.