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 $199.53 Median $4,466.84 Typical High $9,772.37 | Facility | None | $199.53 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $446.68 | Professional | None | $173.78 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $478.63 Typical High $2,187.76 | Facility | None | $269.15 | $478.63 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $549.54 | Professional | None | $173.78 | $316.23 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $645.65 | Professional | None | $446.68 | $602.56 | $645.65 |
Horizon BCBS Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $1,513.56 | Facility | None | $363.08 | $645.65 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $588.84 | Professional | None | $213.80 | $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 $104.71 Median $213.80 Typical High $467.74 | Professional | None | $104.71 | $213.80 | $467.74 |
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 $87.10 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $87.10 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $34.67 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $128.82 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $26.30 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.38 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $120.23 | $190.55 | $229.09 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$302
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.