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 $363.08 Median $6,918.31 Typical High $12,882.50 | Facility | None | $363.08 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $457.09 | Professional | None | $275.42 | $363.08 | $457.09 |
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 $218.78 Median $380.19 Typical High $758.58 | Professional | None | $218.78 | $380.19 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $776.25 | Professional | None | $537.03 | $724.44 | $776.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $1,905.46 | Facility | None | $912.01 | $1,513.56 | $1,905.46 |
Horizon BCBS Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $741.31 | Professional | None | $346.74 | $562.34 | $741.31 |
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 $169.82 Median $275.42 Typical High $645.65 | Professional | None | $169.82 | $275.42 | $645.65 |
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 $138.04 Median $181.97 Typical High $218.78 | Professional | 52 · Reduced service | $138.04 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $54.95 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $204.17 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $190.55 | $257.04 | $302.00 |
Where New Jersey sits
The same service costs 4.7 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· 46th 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.