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 $331.13 Median $6,918.31 Typical High $12,882.50 | Facility | None | $331.13 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $389.05 | Professional | None | $204.17 | $295.12 | $389.05 |
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 $128.82 Median $269.15 Typical High $676.08 | Professional | None | $128.82 | $269.15 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $549.54 | Professional | None | $380.19 | $512.86 | $549.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $3,467.37 | Facility | None | $1,659.59 | $2,754.23 | $3,467.37 |
Horizon BCBS Setting Professional Modifier None Typical Low $229.09 Median $457.09 Typical High $691.83 | Professional | None | $229.09 | $457.09 | $691.83 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $501.19 | Professional | None | $107.15 | $194.98 | $501.19 |
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 $102.33 Median $141.25 Typical High $194.98 | Professional | 52 · Reduced service | $102.33 | $141.25 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $77.62 | Professional | 53 · Discontinued | $40.74 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $208.93 Typical High $288.40 | Professional | 54 · Surgery only | $154.88 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $42.66 Typical High $58.88 | Professional | 55 · Aftercare only | $30.90 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $194.98 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $144.54 | $194.98 | $269.15 |
Where New Jersey sits
The same service costs 4.1 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· 41st of 51
$316
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.