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 $190.55 Median $4,466.84 Typical High $9,772.37 | Facility | None | $190.55 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $446.68 | Professional | None | $162.18 | $257.04 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $812.83 Typical High $2,187.76 | Facility | None | $446.68 | $812.83 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $549.54 | Professional | None | $165.96 | $309.03 | $549.54 |
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 $562.34 Median $1,000.00 Typical High $2,754.23 | Facility | None | $562.34 | $1,000.00 | $2,754.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $588.84 | Professional | None | $208.93 | $398.11 | $588.84 |
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 $102.33 Median $208.93 Typical High $457.09 | Professional | None | $102.33 | $208.93 | $457.09 |
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 $81.28 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $81.28 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $51.29 Typical High $63.10 | Professional | 53 · Discontinued | $32.36 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $120.23 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $23.99 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.70 Typical High $31.62 | Professional | 56 · Pre-op care only | $16.22 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $181.97 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $112.20 | $181.97 | $223.87 |
Where New Jersey sits
The same service costs 3.4 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· 46th 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.