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 $186.21 Median $6,918.31 Typical High $12,882.50 | Facility | None | $186.21 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $218.78 | Professional | None | $104.71 | $186.21 | $218.78 |
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 $81.28 Median $151.36 Typical High $380.19 | Professional | None | $81.28 | $151.36 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $380.19 | Professional | None | $263.03 | $354.81 | $380.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $933.25 | Facility | None | $446.68 | $676.08 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $416.87 | Professional | None | $128.82 | $257.04 | $416.87 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $63.10 Median $131.83 Typical High $295.12 | Professional | None | $63.10 | $131.83 | $295.12 |
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 $52.48 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $52.48 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $33.88 Typical High $44.67 | Professional | 53 · Discontinued | $20.89 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $128.82 Typical High $165.96 | Professional | 54 · Surgery only | $79.43 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.70 Typical High $33.11 | Professional | 55 · Aftercare only | $15.85 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $10.47 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $120.23 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $74.13 | $120.23 | $154.88 |
Where New Jersey sits
The same service costs 3.8 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· 44th of 51
$186
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.