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 $85.11 Median $3,467.37 Typical High $10,000.00 | Facility | None | $85.11 | $3,467.37 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $173.78 | Professional | None | $53.70 | $102.33 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $257.04 | Professional | None | $69.18 | $128.82 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $269.15 | Professional | None | $186.21 | $251.19 | $269.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $1,905.46 | Facility | None | $912.01 | $1,513.56 | $1,905.46 |
Horizon BCBS Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $257.04 | Professional | None | $91.20 | $173.78 | $257.04 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $47.86 Median $89.13 Typical High $204.17 | Professional | None | $47.86 | $89.13 | $204.17 |
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 $26.92 Median $51.29 Typical High $75.86 | Professional | 52 · Reduced service | $26.92 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $20.42 Typical High $30.20 | Professional | 53 · Discontinued | $10.72 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $75.86 Typical High $112.20 | Professional | 54 · Surgery only | $39.81 | $75.86 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $15.14 Typical High $22.39 | Professional | 55 · Aftercare only | $7.94 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.23 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.37 | $10.23 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $70.79 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $37.15 | $70.79 | $104.71 |
Where New Jersey sits
The same service costs 4.5 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
$117
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.