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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $208.93 | Professional | None | $109.65 | $158.49 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $239.88 Typical High $371.54 | Facility | None | $134.90 | $239.88 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $154.88 Typical High $316.23 | Professional | None | $83.18 | $154.88 | $316.23 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $331.13 | Professional | None | $234.42 | $309.03 | $331.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $245.47 Median $436.52 Typical High $1,513.56 | Facility | None | $245.47 | $436.52 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $331.13 | Professional | None | $134.90 | $239.88 | $331.13 |
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 $63.10 Median $117.49 Typical High $275.42 | Professional | None | $63.10 | $117.49 | $275.42 |
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 $54.95 Median $79.43 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $31.62 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $83.18 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.99 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.85 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.96 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $125.89 |
Where New Jersey sits
The same service costs 3.5 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· 48th of 51
$170
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.