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 $2,754.23 Median $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $229.09 | Professional | None | $120.23 | $177.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $309.03 Typical High $1,659.59 | Facility | None | $173.78 | $309.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $354.81 | Professional | None | $93.33 | $173.78 | $354.81 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $371.54 | Professional | None | $263.03 | $354.81 | $371.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $275.42 Median $489.78 Typical High $1,513.56 | Facility | None | $275.42 | $489.78 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $380.19 | Professional | None | $151.36 | $269.15 | $380.19 |
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 $70.79 Median $131.83 Typical High $309.03 | Professional | None | $70.79 | $131.83 | $309.03 |
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 $60.26 Median $89.13 Typical High $102.33 | Professional | 52 · Reduced service | $60.26 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $24.55 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $151.36 | Professional | 54 · Surgery only | $91.20 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $18.20 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.02 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $125.89 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $85.11 | $125.89 | $141.25 |
Where New Jersey sits
The same service costs 3.5 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· 45th of 51
$195
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.