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 $380.19 Median $6,918.31 Typical High $12,882.50 | Facility | None | $380.19 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $426.58 | Professional | None | $288.40 | $380.19 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $478.63 Typical High $1,659.59 | Facility | None | $269.15 | $478.63 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $724.44 | Professional | None | $218.78 | $380.19 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $724.44 | Professional | None | $501.19 | $676.08 | $724.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $1,513.56 | Facility | None | $338.84 | $630.96 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $870.96 | Professional | None | $354.81 | $537.03 | $870.96 |
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 $165.96 Median $263.03 Typical High $630.96 | Professional | None | $165.96 | $263.03 | $630.96 |
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 $141.25 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $141.25 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $75.86 Typical High $85.11 | Professional | 53 · Discontinued | $57.54 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $213.80 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $42.66 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $28.84 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $199.53 | $263.03 | $295.12 |
Where New Jersey sits
The same service costs 6.0 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· 47th of 51
$380
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.